The patient is pronounced. The following week, your medical director reviews the case with you. Alcohol and hepatitis C are the most common causes of cirrhosis. As the liver is destroyed, the pressure in the blood vessels backs up, distending the thin walled veins. Airway control is a challenge at best.
Prehospital treatment is rapid transport, airway and fluid replacement, if possible.
As you can see, not all bleeding can be controlled by direct pressure, elevation or tourniquet. Anything that delays transport will only cause further negative patient impact.