Bleeding should be managed as severe, life-threatening bleeding in the following situations:
- Amputated or partially amputated limb above wrist or ankle.
- Shark attack, propeller cuts or similar major trauma to any part of the body.
- Bleeding not controlled by local pressure.
- Bleeding with signs of shock, i.e., pale and sweaty plus pulse rate >100, or capillary refill > 2 sec and/or decreased level of consciousness.