Assess for unrecognized hemorrhage and control all sources of bleeding. Signs and symptoms of massive hemorrhage include:

- Pulsatile (or arterial) bleeding, distinguished by its bright red appearance
- Steady bleeding, which can be gushing arterial or even venous from a larger vein being disrupted
- Blood pooling on the ground
- Blood soaking overlying clothing
- Blood flowing at the site of a traumatic amputation of an arm or leg
- Blood-soaked bandages, which generally indicate that the injury requires a tourniquet or the wound wasn’t packed and bandaged correctly