Approach to extremity injury Quiz: Ace Your Exams

A 42-year-old man presents to the emergency department after sustaining a deep right wrist laceration while working at a construction site. The patient was carrying a piece of sheet metal that fell, resulting in the injury. The patient has no significant past medical history and takes no medication. Last Tdap was administered 13 years ago. Temperature is 37.0°C (98.6°F), heart rate is 116/min, respiratory rate is 20/min, blood pressure is 92/64 mmHg, and oxygen saturation is 98% on room air. On primary survey, the patient speaks in clear full sentences with bilateral breath sounds. Capillary refill is > 4 seconds in the right upper extremity and brisk in the left upper and bilateral lower extremities. Glasgow coma score is 15. The patient appears pale. On secondary survey, there is pulsatile bleeding from the right wrist wound with pooling of blood. Which of the following is the best next step in management?