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Using direct pressure on the wound is the most effective and immediate method to control severe bleeding from an arm injury. Applying direct pressure helps to compress the blood vessels at the site of the injury, which can significantly reduce or stop the flow of blood. It's essential to use a clean cloth or bandage, and if blood soaks through, additional layers can be added without removing the initial dressing, as removing it may disrupt any clotting that has begun.

While applying a tourniquet is a valid method for severe bleeding, especially in the context of life-threatening injuries, it is typically considered a last resort when direct pressure fails or when there is a serious risk to life. Direct pressure should always be the first step in addressing bleeding before more invasive measures are considered.

Letting the individual apply pressure themselves may not be effective, as they might not apply the necessary amount of pressure or may not be able to maintain it consistently.

Keeping the injury elevated without applying pressure is not sufficient in cases of severe bleeding, as elevation alone does not address the immediate need to control blood loss effectively.