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Life-threatening extremity hemorrhage that is not controlled by firm, direct pressure warrants rapid tourniquet application. Place a commercial tourniquet 2–3 inches proximal to (closer to the torso than) the wound, avoiding joints. Tighten until bleeding stops and distal pulses are absent; then record the time of application. Tourniquets are safe and effective when used correctly and can be lifesaving by preventing exsanguination. Option A (elevation) is no longer a primary hemorrhage control step and should not delay definitive control. Option C (wound packing) is more appropriate for junctional or deep cavity bleeding; for mid-forearm arterial bleeding, a tourniquet is faster and more reliable. Option D risks loss of any clot that has formed; when converting or reassessing, do not repeatedly remove effective dressings if bleeding is controlled. After the tourniquet, manage for shock (keep warm, high-flow oxygen as indicated), reassess frequently, and expedite transport to a trauma-capable facility.