Two patients were struck by a car. An 8 year old female is pulseless, apneic and pinned at the waist. A 44 year old male has bilateral lower extremity amputation with profuse bleeding. He screams "Help my baby." What should you do?

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In trauma care, stopping life-threatening bleeding is the immediate priority because a patient can die from hemorrhage within minutes. A tourniquet is the fastest and most effective way to control severe limb bleeding when direct pressure isn’t enough or when an injury involves amputation. The adult in this scenario has bilateral lower-extremity amputations with profuse bleeding, so applying tourniquets to those limbs is the best move right away to save his life.

The child is pulseless and apneic, which would normally require CPR, but with two victims and active major bleeding, you address the most time-critical threat first. Controlling the adult’s hemorrhage now improves overall survival chances for both patients; delaying hemorrhage control to start CPR on the child would be less life-saving in the moment.