Your patient is a 26-year-old male who was involved in an altercation. He has a severe laceration to the upper arm after being pushed through a large storefront window. Bystanders reported bright red blood spurting from the patient’s wounds. A bystander applied direct pressure to the wound with a towel prior to your arrival, but the patient continues to bleed and appears pale. This patient likely suffered a laceration of the ________, and your first priority should be to ________.