NREMT Emergency Medical Technician (EMT) Cognitive ExamTraumaEasy
A 38-year-old male was involved in a motorcycle accident and sustained an open fracture to his right tibia. He is complaining of severe pain, and you observe bone protruding through the skin. After addressing any life-threatening issues, what is the MOST appropriate next step in managing this injury?
- AClean the exposed bone thoroughly with an antiseptic solution.
- BCover the open wound with a sterile dressing and splint the extremity in the position found.
- CApply a tourniquet immediately above the injury to prevent further bleeding.
- DAttempt to reduce the fracture by pushing the bone back into the skin.
Show answer & explanationAnswer & explanation
Correct answer: B. Cover the open wound with a sterile dressing and splint the extremity in the position found.
For an open fracture, the priority after addressing immediate life threats is to prevent further contamination and stabilize the injury. Covering the wound with a sterile dressing minimizes infection risk, and splinting in the position found prevents further damage to tissues and neurovascular structures.
Why the other options are wrong
- A. Cleaning exposed bone in the field is beyond the EMT scope of practice and can introduce more contaminants or cause further damage.
- C. A tourniquet is only indicated for severe, uncontrollable arterial bleeding; it is not the primary treatment for an open fracture unless such bleeding is present.
- D. Attempting to reduce an open fracture in the field can cause further injury, contamination, and pain.
Open Fracture Management
An open fracture involves a break in the bone where the skin is also broken, exposing the bone to the outside environment.
- High risk of infection due to contamination.
- Do not attempt to reduce the fracture.
- Prioritize sterile dressing and immobilization.
Memory trick: Open bone, sterile cover, then stabilize the zone.