If bleeding has not been controlled:

- If packed with hemostatic dressing, remove prior packing material and repack starting at step 3.
- If packed with gauze or other materials, apply additional gauze/materials and pressure (for another 3 minutes) until bleeding has stopped.

All dressings for significant bleeding should be secured with a pressure bandage while maintaining pressure on the wound throughout the process of applying the pressure bandage.

Also, wound packing and pressure bandage application can be used at this stage for larger bleeding wounds that were not previously addressed, but that should be controlled prior to the wound phase (or the “W” of MARCH-PAWS).