What is the recommended approach to an open fracture with visible bone in the field?

• A. Control bleeding, cover wound with sterile dressing, immobilize with splint, evac promptly
• B. Remove bone fragments
• C. Push bone back into place
• D. Evacuate without dressing or splint

Answer: (A)

Dealing with an open fracture in the field requires immediate steps to limit infection and further injury. The best approach is to control any bleeding, cover the wound with a sterile dressing to seal out dirt and bacteria, immobilize the limb with a splint to prevent movement, and evacculate promptly to a medical facility. This sequence reduces infection risk, stabilizes the injured area, and gets the patient into definitive care for debridement and antibiotics. Removing bone fragments, pushing bone back into place, or evacuating without dressing or splint can worsen injury, introduce contaminants, or leave the limb unstable, which is why they are not appropriate.