NREMT Emergency Medical Technician (EMT) Cognitive ExamTraumaEasy
A 32-year-old male presents with a painful, swollen, and deformed right forearm after falling off a ladder. He denies numbness or tingling. There is no open wound. Which of the following is the MOST appropriate initial management for this injury?
- AAdminister pain medication and transport immediately without splinting.
- BImmobilize the forearm in the position found using a splint.
- CAttempt to realign the deformity before splinting.
- DApply a tourniquet proximal to the injury.
Show answer & explanationAnswer & explanation
Correct answer: B. Immobilize the forearm in the position found using a splint.
For a closed, deformed extremity injury without neurovascular compromise, the most appropriate initial management is to immobilize the limb in the position found to prevent further injury and reduce pain. Realignment should generally only be attempted by advanced providers or when distal circulation is compromised.
Why the other options are wrong
- A. Administering pain medication is important, but immediate transport without proper splinting risks further injury and increased pain during transit.
- C. Attempting to realign a fracture can cause further injury, nerve damage, or convert a closed fracture to an open one, and is generally outside the scope of EMT practice unless specific indications (like absent distal pulse) are present and protocols allow.
- D. Tourniquets are used for severe, uncontrollable arterial bleeding, not for closed fractures.
Fracture Immobilization (Position Found)
The principle of immobilizing a suspected extremity fracture in the position it is found, without attempting to realign it, to minimize further injury, pain, and potential complications.
- Prevents further soft tissue or nerve damage.
- Reduces pain for the patient.
- Avoids converting a closed fracture into an open fracture.
- Realign only if distal circulation is compromised and protocols allow.
Memory trick: Found It, Fix It (in place)!