If a wound packed with hemostatic gauze continues to bleed after 3 minutes of direct pressure, remove the packing material and repack with a new hemostatic gauze, if available. This allows fresh, inactivated, clotting agents to come in contact with the source of bleeding and will hopefully lead to clot formation and hemorrhage control.
However, if additional hemostatic gauze is not available or the wound was packed with a non-hemostatic gauze dressing, reinforce the dressing with additional non-hemostatic gauze, apply direct pressure for three minutes, and then apply a pressure bandage to control the bleeding.