A young adult with a severed artery following an automobile accident

A 32-year-old female was brought to the emergency department following an automobile accident with major arterial bleeding. Emergency medical services reported a significant bleeding suspected from a severed femoral artery. She was conscious, appeared pale and weak. EMS reported about 600mL of blood loss, they applied torniquet at the right leg to control the bleeding and started an IV line of normal saline.  

On arrival, her blood pressure was 90/60 mmHg, heart rate of 120 bpm, respiratory rate of 22 breaths per minute, temperature of 36.5 C. The patient is pale, diaphoretic, and anxious. The patient is otherwise healthy and has no other significant past medical history. CNS examination reveals a GCS score of 15 and the patient is alert and oriented. Cardiovascular examination indicates tachycardia with a regular rhythm, weak peripheral pulses, delayed capillary refill. On auscultation, patient is tachypenic, but breath sounds are clear bilaterally. A complete blood count indicates hemoglobin of 10g/dL, hematocrit of 30% and other parameters within normal range. Blood coagulation shows PT, aPTT and INR within normal range. A X-ray of the affected lower limb reveals no fractures but soft tissue swelling.