You have a major jugular vein laceration. You must immediately?

• A. Stop the bleeding with gauze and a pressure dressing
• B. Clamp the vessel with a hemostat
• C. Apply an occlusive dressing
• D. Tie the vessel off with surgical string

Answer: (C)

Sealing the wound with an occlusive dressing is the immediate action because neck venous injuries carry a high risk of air entering the torn vein as the patient breathes, which can lead to a dangerous venous air embolism. An occlusive dressing quickly and effectively seals the wound, reducing the chance of air entering the circulation while you can continue to manage bleeding and monitor the airway. In the field, more invasive maneuvers like clamping or tying off a vessel aren’t appropriate or practical. If there’s active bleeding, you can reinforce with direct pressure as you apply the occlusive dressing, but the priority is to create a sealed wound to prevent air from getting into the venous system.