In cases where direct pressure is not possible, either because the exact source cannot be identified or because it is not amenable to direct pressure, indirect pressure can be used as a temporary measure to effectively control bleeding until a tourniquet or pressure dressing can be applied. It involves applying pressure to the appropriate pressure point to compress the artery proximal to the site of bleeding. The pressure points are located at anatomic areas where the arteries supplying blood to the injured area are superficial enough that they can be manually compressed against the underlying bone or soft tissue structures. This requires a great deal of pressure and, like a tourniquet, is painful when performed correctly.
As with direct pressure, it is hard to use indirect pressure alone to control significant bleeding or while moving a casualty, but it should be attempted while gathering and preparing equipment for more definitive treatments. Do not forget to ask other first responders to assist as needed.