The order of these four Actions really depends on the scenario, but generally, scene safety is paramount. If the scene is safe, and there is life-threatening external hemorrhage, your first step could be tourniquet placement. Each scenario is different, and the ordering of these actions could vary.

There are four major areas for action:

1. Scene Safety
2. Casualty Movement
3. Stop life-threatening external hemorrhage
4. Proper Communication

### Scene Safety

First, you must ensure the scene is safe for you to enter. You can help others who may be working to secure the scene, or you may have to do what you can to

make the scene safe to enter (return gunfire, firefighting etc.). You can’t risk your personal safety, the risk of injury to other personnel, or the safety of your casualty.

### Casualty Movement

Move the casualty to a safer area due to a real or potential threat that exists in the environment. In that case, you must quickly develop a casualty movement plan that takes into account these important considerations: the location of the nearest cover, how best to move yourself or the casualty, the weight of the casualty, and the distance to be covered.

### Stop Life-Threatening External Hemorrhage

Place one or more hasty tourniquet(s) (in a “high and tight” manner) to an arm or leg to control life-threatening external hemorrhaging. This should be accomplished in less than 1 minute. If the casualty is conscious, you may direct the casualty to render self-aid and apply a tourniquet to him/herself, if they have one.

### Proper Communication

Once you are able to reach the casualty safely and have taken any other precautions through proper communication, you must:

- Communicate with the casualty as soon as possible, maybe even before you have moved the casualty to a safe area, to determine if they are awake, confused, or disoriented. If they are awake, let them know you are there to help.
- Request assistance from first responders or other medics, if available. Rarely are you alone in these circumstances.