Hey NorthManLogging,
What you're sayin bout direct pressure to minimize arterial bleeding is spot on and undoubtably true when it comes to chest punctures no doubt.
How you gonna put a tourniquet on a chest puncture? Direct pressure works, as long as it's able to give a bit with the breathing cycle.
Many years ago a Moto-X buddy of mine got too squirrelly on an extremely steep downhill section of a course we were riding, got too far into the weeds, and had a manzanita stub spear him off his bike, leaving him impaled through his chest protector, jersey and chest like a rag doll.
Being the next rider above and behind him I witnessed it happening, threw my bike down hill, rushed to his assistance, and physically pulled him off the manzanita stub.
At which point arterial blood sprayed profusely from the injury. Instinctively I ripped his chest protector off, got under his jersey and applied direct pressure to the wound with my right hand sufficient to stop the outward blood loss, while using my left hand to gain leverage leverage against his back. He complained violently bout not being able to breathe, but I knew he could because I could feel his chest expanding and retracting between my two hands. I was latched to him like a bulldog in full Moto-X regalia, and never felt his blows aimed at me thanks to helmet etc.
The nightmare was maintaining that pressure and coordinating the transport logistics during the crisis, even with six people and three vehicles assisting. We stuffed him on a lounge chair, got him into the back of a Ford Ranchero for transport, but the driver was so distraught he slid off the main road into deep sand and got stuck. The victim's brother was in the back of the Ranchero with me, sobbing in fear of his brother dying, not comprehending that unless he went back to the track and got a friend's 4x4 ASAP, his brother really would die. I had to let go with my left hand at his back long enough to slap him out of his stupor and run back to the track.
Meanwhile the driver of the Ranchero was so furious with himself for running off the road and getting stuck, he was doing the old forward gear and floor it, quickly followed by reverse gear and floor it. After a few minutes of this he managed to creep back onto the main road and complete our trip to the Apple Valley Hospital.
Well over 30 minutes went by before he was in the ER's hands. I distinctly remembered getting there still latched to my riding buddy like a leach, demanding who the doc was that'd take my spot applying pressure to the wound? As he stepped next to me in the ER, saying yes I can relieve you, the blood spray hitting his clean gown as his rubber gloved hands replaced my leather gloved hand.
Lucky for the victim, that branch just punctured his ribs and chest, barely scraping his lung on that side, or he'd of been a dead door nail within a few minutes of the accident.
So yeah, direct pressure on arterial bleeding works. But a truly punctured lung demands some kinda seal, like a Baggie, Saran Wrap or something to keep from suckin air, ASAP.
Stayin calm during these types of traumatic incidents is the key to a successful outcome in some cases, atleast in my exposure to them over the years.
jomoco