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Junctional hemorrhage (axilla, groin, neck) cannot be controlled with standard circumferential limb tourniquets because there is no compressible long bone to occlude. The recommended immediate intervention is aggressive wound packing with a hemostatic dressing (e.g., chitosan or kaolin-based), applied directly at the source of bleeding, followed by sustained manual pressure for several minutes and a secure pressure dressing. Junctional tourniquet devices may be used if available and trained, but in most field contexts, expert wound packing is the fastest, most accessible solution. Needle thoracostomy addresses tension pneumothorax, not hemorrhage. Direct pressure without packing may be insufficient for deep, high-flow junctional wounds. Attempting a “high-and-tight” limb tourniquet above the pelvis is anatomically ineffective. After initial control, monitor for rebleeding, consider pelvic stabilization if pelvic injury suspected, and expedite evacuation.