How does severe bleeding manifest in an ill or injured passenger?

Severe bleeding in an ill or injured passenger typically manifests as excessive blood loss, which can be visibly or significantly noticeable. When a passenger is experiencing severe bleeding, it can lead to a rapid loss of blood volume, which can compromise oxygen delivery to vital organs and potentially cause shock. Excessive blood loss may also present with signs such as pale skin, rapid heart rate, cold or clammy skin, and changes in consciousness.

The other options do not specifically indicate severe bleeding. Inability to breathe may relate to respiratory issues or airway obstructions rather than bleeding. Loss of consciousness can be a result of several conditions, including trauma or shock from blood loss, but it is not a direct manifestation of bleeding itself. Prolonged coughing can suggest respiratory issues or trauma to the thoracic area but is not a primary symptom of severe bleeding. Thus, indicating excessive blood loss as the direct manifestation of severe bleeding is crucial for recognizing the condition and responding appropriately in an emergency situation.