NREMT Paramedic Cognitive ExamTraumaMedium
A 68-year-old female fell, sustaining an angulated open fracture of her left tibia. She has a strong distal pulse, warm skin, and good capillary refill. After controlling bleeding and covering the wound with a sterile dressing, what is the next most appropriate intervention for the angulation?
- AImmobilize in the position found.
- BApply a traction splint.
- CAdminister pain medication and transport immediately.
- DAttempt gentle manual realignment.
Show answer & explanationAnswer & explanation
Correct answer: D. Attempt gentle manual realignment.
For an angulated fracture with an intact distal neurovascular status, gentle manual realignment (reduction) is indicated as it can reduce pain, prevent further soft tissue injury, and facilitate splinting. This should be done before definitive splinting.
Why the other options are wrong
- A. Immobilizing in the position found is generally for fractures without angulation or with compromised distal neurovascular status where realignment could worsen it.
- B. Traction splints are for femur fractures, not angulated open tibia fractures.
- C. While pain medication is important, it's not the next most appropriate intervention for the angulation itself before splinting.
Fracture Realignment
The process of gently restoring an angulated fracture to a more anatomical position to reduce pain, prevent further injury, and facilitate splinting.
- Indicated for angulated fractures with intact distal neurovascular status.
- Performed gently and with continuous assessment of neurovascular status.
- Aids in proper splint application.
Memory trick: Open Fracture Angulation: Realignment Rescues.