If a casualty has a fracture that protrudes out of the skin, what is your primary concern at this time?

In a situation where a casualty has a fracture that protrudes out of the skin, the primary concern must be controlling any life-threatening bleeding. An open fracture not only exposes the bone but also the surrounding soft tissue and blood vessels, increasing the risk of significant blood loss.

Bleeding can rapidly lead to shock, which is a critical condition that requires immediate attention. Ensuring that blood loss is controlled is paramount to stabilizing the casualty and preventing further complications.

While keeping the wound clean and dry, irrigating the wound, and realigning the fracture are important considerations in fracture management, they become secondary to addressing the immediate threat posed by significant bleeding. Effective management of life-threatening events is always prioritized in emergency care situations.