You have responded to a local residence of a 37-year-old male who had lacerated his leg while using a chainsaw in the back of his house. Before your arrival, the patient's wife, who is a nurse, applied pressure to the wound and has the patient in a Trendelenburg position. Your assessment of the patient reveals him to be responsive to painful stimuli with a weak carotid pulse and the blood pressure unobtainable. There is a massive amount of blood surrounding the patient on the ground. The wife tells you that the wound is arterial and the injury occurred about 10 to 15 minutes ago. In addition to oxygen therapy, what are your treatment priorities for this patient?

In this scenario, the patient is experiencing severe bleeding and is in shock. As a result, the top priority for treatment should be to control the bleeding to prevent further blood loss and stabilize the patient's condition. Therefore, the appropriate action would be to continue applying direct pressure to the wound and call for ALS (Advanced Life Support) support immediately.
Applying an arterial tourniquet is a last resort measure, as it can result in the loss of the limb and significant complications. Therefore, it should only be considered if direct pressure fails to control the bleeding.
Transportation should only occur after the patient's condition has been stabilized. In this case, the patient is in shock, and transportation without stabilizing the patient's condition could lead to further deterioration and potential cardiac arrest.
In summary, the correct treatment priorities for this patient are to control the bleeding by continuing to apply direct pressure to the wound and calling for ALS support immediately.