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Oral Surgery · single question

After a tooth extraction, the socket is bleeding excessively. What is the FIRST step?

  1. Place Gelfoam absorbable gelatin sponge in the socket
  2. Apply firm pressure with gauze (have patient bite down)
  3. Suture the socket closed immediately
  4. Administer IV tranexamic acid
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Correct answer: B. Apply firm pressure with gauze (have patient bite down)

The FIRST and most fundamental step for post-extraction hemorrhage is DIRECT PRESSURE — have the patient bite firmly on folded gauze for 20–30 minutes without peeking. This activates primary hemostasis. All other measures (Gelfoam, sutures, tranexamic acid) are secondary interventions when direct pressure alone is insufficient.
  • A. ❌ Gelfoam is a secondary hemostatic adjunct — used if pressure is insufficient; not the first step.
  • B. ✅ Firm pressure with gauze — ALWAYS the first step for post-extraction bleeding; activates primary hemostasis.
  • C. ❌ Suturing is a secondary measure — done only if pressure fails.
  • D. ❌ Tranexamic acid is an adjunct for patients on anticoagulants — not the initial first-line measure.

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