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Open fracture analgesia — DipIMC MCQ

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HardTraumaOpen fracture analgesiaDipIMC

A 27-year-old has an open tibial fracture contaminated with soil. Haemorrhage is controlled, the limb is aligned and neurovascular status documented. Which infection-prevention step should occur during emergency management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Give IV prophylactic antibiotics as soon as possible

The best answer is “Give IV prophylactic antibiotics as soon as possible”. NICE recommends IV prophylactic antibiotics immediately for open fractures, ideally within one hour of injury. Pre-hospital wound handling should be limited to removing gross contamination, photographing when appropriate and applying a saline-soaked occlusive dressing; irrigation and closure occur in the proper surgical pathway. Cultures do not justify delaying prophylaxis in a visibly open, contaminated long-bone injury.

Reference: NICE NG37, Fractures (complex): https://www.nice.org.uk/guidance/ng37/chapter/recommendations