What is the first step in the general care of major external bleeding?

Applying a dry sterile dressing and bandaging firmly is the correct first step in managing major external bleeding because it helps to directly control the bleeding at the site of the injury. By using a sterile dressing, you minimize the risk of introducing infection into an open wound and help to promote clotting by applying direct pressure. Firm bandaging also aids in maintaining pressure on the wound, which is essential for reducing blood loss until more advanced medical help can be obtained.

Applying a tourniquet immediately is typically reserved for more severe cases where direct pressure is ineffective, and the bleeding cannot be controlled by other means. It may also cause complications, such as loss of limb if not applied correctly. Advising the casualty to see a doctor on arrival does not address the immediate need for bleeding control and could delay necessary treatment. Monitoring the casualty for shock is important but should be done concurrently with applying a dressing, as controlling the bleeding is the priority in the initial care of the injury. Hence, the application of a dry sterile dressing is a critical first step in managing external bleeding effectively.