As with neck wounds, junctional hemorrhage from a wound to the axilla can be similarly challenging to treat in TFC.
The wound should be exposed, packed with hemostatic gauze mounded to at least 1-2 inches above the skin, and direct pressure applied continuously for a minimum of 3 minutes.
After bleeding has been controlled, continue to maintain pressure on the wound. Wrap a pressure (or elastic) bandage circumferentially around the shoulder and under the armpit twice on the affected side, ensuring that the hemostatic dressing underneath is completely covered. Wrap the pressure (or elastic) bandage diagonally across the body and under the opposite armpit and around the shoulder, and back across the body in a “figure 8” technique. Secure it with a nonslip knot or a securing device (depending on what type of bandage is used). Swath the upper arm on the injured side to the chest using a cravat.
The “figure 8” elastic bandage helps to maintain pressure on the wound when both arms are down at the casualty’s side. Continue to reassess for hemorrhage control, especially after casualty movement.
Do not forget to ask other first responders to assist as needed.