What should you do if the combination elevation and direct pressure do not control the bleeding?

The loss of a small amount of blood will cause no problem for a healthy adult, loss of one liter of blood is life-threatening and the loss of two litres is fatal.The first step to control bleeding is the application of direct pressure to the wound using a dressing or a clean cloth. An assisting person should wear gloves to protect from the blood-borne diseases HIV and hepatitis.A bleeding extremity should be elevated above the level of the heart. In cases of severe, persistent bleeding, application of pressure where a local artery can be pressed against the bone to slow the bleeding.Bleeding from the upper extremities is controlled by putting pressure on the 'biracial artery', which may be pressed against the arm bone by a push inward along the natural groove between the bicep and triceps.Bleeding from the lower extremities is controlled by putting pressure on the 'femoral artery', which is found in the groin.*It is important not to leave the pressure on too long, as this may cause damage to tissues supplied by arteries past the pressure point.*