the  left  side  of  the  body.  This  figure  also  shows pressure  points  for  the  left  superficial  temporal, common  carotid,  brachial,  femoral,  and  popliteal arteries. Whether you use a pressure point on the left side or the right side of the casualty depends on the side where the wound is found. You must also select the pressure point that is nearest the wound, and between the wound and the main part of the body. The following paragraphs discuss the pressure points used to control hemorrhage in different areas of the  body.  Throughout  the  discussion,  refer  to  figure 13-5. For bleeding of the temple, forehead, and scalp, apply pressure to the superficial temporal artery just in front of the upper part of the ear. For bleeding of the  cheeks, lips,  or  chin,  apply pressure to the facial artery. To find the pressure point, start at the angle of the mandible until you feel a small notch. The pressure point is in this notch. For bleeding of the neck, apply pressure to the common carotid artery on the side of the neck. You can detect a very strong pulse. At a point below the wound, press  inward  and  slightly  backward  against  the pressure point. WARNING Do not use this pressure point unless it is absolutely necessary, because there is great danger  of  compressing  the  windpipe  and choking the casualty. Never apply pressure to the pressure points on both sides of the neck at the same time. For bleeding at the shoulder and upper part of the arm, apply pressure to the subclavian artery under the front part of the collarbone. You can press down against the first rib or forward against the collarbone. For bleeding between the middle of the upper arm and the elbow,  apply pressure to the upper portion of the brachial artery on the inner side of the arm, about halfway between the shoulder and the elbow. For bleeding between the middle of the upper arm and the elbow,  apply pressure to the upper portion of the brachial artery on the inner side of the arm, about halfway between the shoulder and the elbow. For bleeding of the lower arm (forearm), apply pressure to the lower portion of the brachial artery on the inner side of the arm at the bend of the elbow. For bleeding of the  hand,  apply pressure to the radial and ulnar arteries at the wrist. For  bleeding  at  the  thigh,  apply pressure to the iliac artery in the middle of the groin. It may be more effective to apply pressure to the femoral artery in the upper thigh. If you use this pressure point, apply pressure with the closed fist of one hand and use the other  hand  to  give  additional  pressure.  The  femoral artery at this point is deeply buried, so great pressure is needed to compress the artery against the bone. For bleeding of the lower leg, apply pressure to the popliteal artery on the back of the leg, behind the knee. If you are unable to apply enough pressure with your fingers, hold the front of the knee firmly with one hand. With your other hand, make a fist and thrust it firmly against the back of the knee. For bleeding of the foot, apply pressure to the anterior and posterior tibia1 artery at the ankle. It is difficult to maintain pressure on a pressure point for more than 15 minutes. If you find you are no longer able to maintain pressure and there is no one to relieve you, you must find another way to control the bleeding. A dressing fixed securely over the wound may be enough. If this controls the bleeding, treat the casualty for shock and then complete the U.S. Field Medical Card. If you are unable to control the serious bleeding with the  dressing,  and  if  the  wound  is  in  one  of  the extremities (arms or legs), you may have to apply a tourniquet. TOURNIQUETS. —Tourniquets  are  used  as  a last resort, and then only for controlling bleeding in the extremities. If you cannot control serious bleeding in an extremity by applying direct pressure, elevation, or by using the appropriate pressure point, you may apply a tourniquet. You will rarely have to apply a tourniquet. When you do, it will most likely be a situation when part of an extremity is amputated (cut off). A tourniquet consists of a pressure pad, a band, and a device for tightening the band. Place the pressure pad over  the  main  artery  supplying  blood  to  the  injured extremity.  Wrap  the  band  around  the  extremity  and over the pressure pad. Tighten the band only enough to shut off the supply of blood to the injured extremity. 13-6