In cases of severe bleeding when direct pressure and elevation are not controlling the bleeding, indirect pressure must be used. Bleeding from an artery can be controlled by applying pressure to the appropriate pressure point. Pressure is applied with the fingers, thumb, or heel of the hand. Pressure points should be used with caution. Indirect pressure can cause damage to the extremity due to inadequate blood flow.
Indirect pressure is used in addition to direct pressure and elevation.
The brachial artery is used to control severe bleeding of the lower part of the upper arm and elbow. It is located above the elbow on the inside of the arm in the groove between the muscles. The femoral artery is used to control severe bleeding of the thigh and lower leg. It is located on the front, center part of the crease in the groin. If the bleeding is not controlled, it may be necessary to press directly over the artery with the flat surface of the fingertips and to apply additional pressure on the fingertips with the heel of your other hand.