How should limb injuries be immobilized before evacuation?

• A. Apply padding, immobilize with splints, ensure joints above and below are stabilized; check distal pulses.
• B. Bandage loosely and move patient quickly.
• C. Immobilize only the fractured limb, ignore joints above/below.
• D. Use crutches to support weight-bearing.

Answer: (A)

The main idea is to prevent further damage and protect blood flow by immobilizing the entire injured area and the joints above and below before moving the patient. Start with padding to protect the skin and soft tissues from the splint edges. Place a rigid splint along the limb that covers the fracture and extends beyond the joints above and below, then secure it so the limb cannot bend at the fracture. Stabilize the joints above and below as well, because movement at those joints translates into movement at the fracture site and can worsen internal injuries. Check distal pulses, and also assess sensation and motor function both before and after immobilization and during transport to detect any compromise in circulation or nerves. If pulses are weak or absent, adjust the splint and seek urgent care. Keep the limb in a comfortable, natural position, prevent unnecessary movement, and avoid trying to realign bones. Keep the patient warm and calm while arranging evacuation.

Other approaches either allow movement that can worsen the injury, fail to protect circulation, or rely on methods that don’t immobilize effectively, which is why they’re not suitable for pre-evacuation care.