What is an appropriate first step in managing a large open wound?

The appropriate first step in managing a large open wound is to control bleeding with direct pressure. This action is critical because large open wounds can lead to significant blood loss, which can quickly become life-threatening. Applying direct pressure helps to slow or stop the bleeding, allowing for stabilization before other interventions are taken.

Once bleeding is controlled, other steps can be taken, such as cleaning the wound or applying dressings. However, controlling bleeding is the immediate priority in any trauma situation. This principle is foundational in emergency care, as it directly addresses one of the most serious complications of severe wounds.