Firefighters are extricating the driver of a small car that was struck broadside by a delivery truck at a moderate rate of speed. The patient was unrestrained, and the car sustained severe damage to the driver's side. As the male patient is pulled from the car, you note severe deformity to his left thigh area where an open femur fracture has been bleeding severely. Your primary assessment shows the patient to be responsive to painful stimuli, with an open airway and adequate breathing at 20 breaths per minute. His radial pulse is present but rapid at a rate of 124. After applying oxygen and stopping the leg bleed with direct pressure, the EMT should immediately:

Here are some guidelines for handling musculoskeletal trauma and nontraumatic fractures: Splinting: Use ample padding when splinting possible fractures, dislocations, sprains, and strains. Splint limbs in the position of function or normal anatomic alignment. If circulation or neurological functions are compromised, gently reposition the limb. This may require administration of pain medications prior to any movement. Immobilization: To perform a reduction of a fracture, EMS providers start by checking for distal circulation, sensation, and motor function. Next, stabilize above and below the... Show more

Here are some guidelines for handling musculoskeletal trauma and nontraumatic fractures:
Splinting: Use ample padding when splinting possible fractures, dislocations, sprains, and strains. Splint limbs in the position of function or normal anatomic alignment. If circulation or neurological functions are compromised, gently reposition the limb. This may require administration of pain medications prior to any movement.
Immobilization: To perform a reduction of a fracture, EMS providers start by checking for distal circulation, sensation, and motor function. Next, stabilize above and below the injury, followed by applying gentle traction to the distal extremity in the direction it is facing.

First aid
For fractures, take these actions right away while waiting for medical help:
Stop any bleeding. Apply pressure to the wound with a sterile bandage, a clean cloth or a clean piece of clothing.
Keep the injured area from moving.
Apply ice packs to limit swelling and help relieve pain.
Treat for shock. 

Closed injuries can be managed with the R.I.C.E.R. regime: Rest, Ice, Compression, Elevation, and Referral for appropriate medical treatment. 

Open injuries can be divided into: Abrasions, Lacerations, Incisions, Punctures, Avulsions, and Amputations. 

Treatment for open injuries includes: Protecting yourself from disease with medical gloves, Washing or irrigating the wound, Controlling bleeding with direct pressure, Applying pressure dressings or an air splint, and Avoiding contamination. 

Show less