Altered being a period of time with abnormal function, i.e not remembering things you should, slurred speech, not thinking normally, not knowing who or where you are. A few seconds is one thing, but minutes is a marker of a hard impact with increased risk of bleeding. Most people will not have bleeding, but death or permanent disability is considered really bad so the acceptable miss rate is really low.
I've not used the powder, gauze just seams easier to manage in my mind. While I have been trained, I have never packed a wound for arterial bleeding as in the ED the preference is to fix it in the OR.
Major bleeding risk on Eliquis is low at about 0.9 % per year, being young your risk is even lower (though not zero). The concern is really none compressible areas like inside the skull or the chest. Alcohol use and NSAIDs (ibuprofen) increase that risk. Don't get stabbed or shot, don't get stomped by a deer, don't fall off a cliff and you should be good.