NREMT Emergency Medical Technician (EMT) Cognitive ExamTraumaMedium
A 68-year-old female presents with severe pain and swelling to her left ankle after twisting it while walking down a curb. She has a history of osteoporosis. Upon examination, you note significant deformity and crepitus. Her distal pulses are strong, and sensation is intact. What is the MOST critical immediate intervention for this patient?
- AAdminister oral pain medication immediately.
- BElevate the injured limb above heart level.
- CImmobilize the ankle with a rigid splint.
- DApply a cold pack to the ankle to reduce swelling.
Show answer & explanationAnswer & explanation
Correct answer: C. Immobilize the ankle with a rigid splint.
Given the significant deformity and crepitus, a fracture or severe sprain/dislocation is highly likely. The most critical immediate intervention is immobilization with a rigid splint to prevent further injury, reduce pain, and stabilize the limb before transport. While cold packs, pain medication, and elevation are beneficial, immobilization takes precedence.
Why the other options are wrong
- A. Administering oral pain medication is important for comfort but does not address the immediate need for stabilization of the injury.
- B. Elevating the limb helps reduce swelling but is not the most critical immediate intervention compared to stabilization for a deformed and potentially fractured ankle.
- D. Applying a cold pack helps with swelling and pain but is secondary to immobilization for a suspected fracture with deformity.
Extremity Fracture Stabilization
The primary management for suspected extremity fractures, involving the use of a splint to immobilize the injured area and adjacent joints to prevent movement, reduce pain, and avoid further injury.
- Prevents further soft tissue, nerve, or vascular damage.
- Reduces patient pain and discomfort.
- Minimizes the risk of a closed fracture becoming an open fracture.
- Always assess neurovascular status before and after splinting.
Memory trick: Stabilize, then Chill and Elevate!