Which action helps identify the source of internal hemorrhage in a patient with altered circulation?

• A. Facilitate FAST and/or radiographs to identify source of internal hemorrhage
• B. Apply a pelvic binder
• C. Start chest compressions
• D. Check capillary refill

Answer: (A)

Identifying where bleeding is coming from as soon as possible is crucial when circulation is compromised. A bedside FAST exam uses ultrasound to quickly detect free fluid in the abdomen, pelvis, or around the heart, which points to an abdominal, pelvic, or pericardial source of hemorrhage. Adding radiographs helps assess chest injuries and pelvic fractures that might be actively bleeding, giving a clearer picture of the source. This imaging approach directly locates the bleeding to guide urgent interventions.

Stabilizing the pelvis with a binder may reduce pelvic bleeding but doesn’t tell you where the bleed is coming from. Chest compressions are a resuscitation measure for cardiac arrest and don’t identify bleeding sources. Checking capillary refill assesses perfusion, not the source of hemorrhage. Therefore, facilitating FAST and/or radiographs best identifies the source of internal hemorrhage in a patient with altered circulation.