Pressure points are specific anatomical locations where a major artery runs close enough to the surface — or against a bony structure — that external pressure can significantly reduce or stop blood flow to a distal wound. They are not a replacement for tourniquets or wound packing. They are a bridge — a way to reduce blood flow to a wound while you or another person prepares definitive hemorrhage control, or a way to slow bleeding at locations where a tourniquet cannot be applied.
This knowledge requires no equipment. Your hands are the tool. That makes it worth knowing.
HOW ARTERIAL PRESSURE POINTS WORK
An artery compressed against an underlying bone can be partially or completely occluded by sustained external pressure. The pressure must be firm, specific, and maintained — casual pressure accomplishes little. The goal is not to bruise the tissue. The goal is to compress the vessel against the bone beneath it with enough force to reduce flow.
Pressure points slow bleeding. They do not necessarily stop it. A major arterial bleed cannot be reliably stopped with pressure point technique alone — it must be followed by definitive hemorrhage control (tourniquet for limb wounds, wound packing for junctional wounds). Use pressure points to reduce blood loss while the definitive intervention is prepared and applied.
PRIMARY ARTERIAL PRESSURE POINTS
BRACHIAL ARTERY — Upper Arm
Location: The inner surface of the upper arm, in the groove between the bicep and tricep muscles. Feel for the pulse in this location — that is the artery.
Use: To reduce blood flow to wounds of the forearm and hand when a tourniquet is being prepared or cannot immediately be applied.
Technique: Grip the upper arm from the outside with the thumb on the outer surface and the fingers on the inner surface. Press the fingers firmly into the groove between the bicep and tricep, compressing the brachial artery against the humerus. Maintain firm, sustained pressure. You are pressing toward the bone, not pinching the muscle.
FEMORAL ARTERY — Upper Thigh / Groin
Location: The groin crease, approximately midway between the anterior superior iliac spine (the bony point of the hip) and the pubic symphysis (the midline bony junction at the front of the pelvis). The femoral pulse is palpable here.
Use: To reduce blood flow to wounds of the thigh, lower leg, and foot when a tourniquet is being applied, or for wounds at the groin junction itself where a tourniquet cannot be placed.
Technique: This requires significant force — the femoral artery is a large vessel under substantial flow pressure, and the surrounding muscle is thick. Place the heel of your hand (or both hands stacked) over the femoral pulse point in the groin crease. Lean your body weight into the compression, pressing toward the pelvis beneath. Light pressure accomplishes nothing. This requires deliberate force.
For junctional wounds at the groin itself, a commercial junctional tourniquet (JETT, SAM Junctional Tourniquet) applies this pressure with a mechanical advantage that hands alone cannot sustain indefinitely.
AXILLARY ARTERY — Armpit
Location: Deep in the axilla (armpit), running along the chest wall.
Use: For wounds of the upper arm and shoulder junction that cannot be reached by a standard tourniquet.
Technique: Press firmly into the armpit toward the chest wall, compressing the axillary artery against the ribs. Less accessible than the brachial point and more difficult to maintain. Used in conjunction with wound packing for axillary wounds.
SUBCLAVIAN ARTERY — Beneath the Collarbone
Location: Runs beneath the clavicle (collarbone), deep in the space above the first rib.
Use: Wounds of the shoulder region above where the axillary technique reaches.
Technique: Direct pressure into the space above the clavicle toward the first rib. Difficult to apply effectively without training. For most shoulder wounds, wound packing is more practical and effective than subclavian pressure point technique.
COMMON CAROTID — NECK
Location: Running vertically along both sides of the neck, lateral to the trachea (windpipe). The pulse is easily palpable.
Use: Neck wounds with active arterial hemorrhage.
Technique: Apply direct manual pressure to the wound itself — not the pressure point proximal to it as with limb wounds. Do not apply circumferential pressure around the neck. Do not compress both carotid arteries simultaneously. Maintain direct pressure to the wound with wound packing if possible.
The neck has no junctional tourniquet solution. Manual pressure and wound packing are the field interventions. Get the patient to surgical care as the priority.
POPLITEAL ARTERY — Behind the Knee
Location: Running through the popliteal fossa — the soft space behind the knee joint.
Use: To reduce blood flow to lower leg wounds as a supplement to lower leg tourniquets.
Technique: With the knee slightly bent, press firmly into the popliteal fossa from behind. Less commonly needed given that lower leg wounds are well managed by tourniquet, but useful to know.
PRACTICAL APPLICATION — JUNCTIONAL WOUNDS
Junctional wounds — those at the groin, armpit, and neck junction — are the most common reason pressure points matter in a trauma scenario. A standard tourniquet cannot be applied high enough to control bleeding from these sites. Options:
Groin wounds:
- Direct wound packing with hemostatic gauze — the primary intervention
- Femoral pressure point to reduce flow while packing is applied
- Commercial junctional tourniquet if available
Axillary wounds:
- Direct wound packing
- Axillary pressure point to reduce flow while packing is applied
- Pressure maintained after packing with a shoulder wrap dressing
Neck wounds:
- Direct manual pressure to the wound
- Wound packing if the wound is deep enough to pack safely
- Pressure maintained — no tourniquet, no wrap around the neck
INTEGRATING PRESSURE POINTS INTO SEQUENCE OF CARE
Pressure points are not a standalone intervention. They fit into the sequence as follows:
- Recognize arterial hemorrhage
- Apply pressure point to reduce flow immediately, with one hand if alone
- Apply tourniquet (limb wounds) or pack the wound (junctional/torso wounds) with the other hand or with assistance
- Maintain tourniquet or packed wound with direct pressure dressing
- Release pressure point once definitive control is in place
For a solo responder: apply direct pressure to the wound first, then transition to tourniquet application. The pressure point technique requires a free hand and is most useful when a second rescuer is present — one applies the pressure point, one prepares and applies the tourniquet or packing.
LEARNING THE ANATOMY
Reading this post is a starting point. The pressure points need to be practiced on a living person with a palpable pulse before they are needed in a crisis. The femoral point in particular requires more force than most people expect — practice finding the pulse in your own groin crease and in a family member. Know what the correct location feels like before you are looking for it under stress.
Stop the Bleed (stopthebleed.org) covers direct pressure and tourniquets. Wilderness First Responder (WFR) and Tactical Combat Casualty Care (TCCC) courses cover junctional hemorrhage control and pressure point techniques in hands-on formats. Both are available to civilians.
WHAT TO STOCK
Pressure points require no equipment. The supporting items for junctional wound management:
- Combat Gauze or Celox hemostatic gauze — 2 rolls minimum
- Israeli pressure bandages — 2 minimum
- SAM Junctional Tourniquet (JETT) — if budget allows ($50-80), for groin and axillary wounds
- Nitrile gloves
Cross-reference: Tourniquet | Wound Packing | Shock — Recognition & Response | Improvised Stretcher