A 24-year-old construction worker presents as triage level 2 with a grossly contaminated open tibia fracture after a crush injury. Distal pulses are

Question

A 24-year-old construction worker presents as triage level 2 with a grossly contaminated open tibia fracture after a crush injury. Distal pulses are present and pain is severe. Tetanus status is unknown. Which of the following is the most appropriate next step in management?

Accepted Answer

IV cefazolin plus gram-negative coverage, tetanus prophylaxis, sterile dressing, and urgent orthopedic consultation

Answer

Closed reduction and discharge with oral cephalexin

Answer

Delay antibiotics until operative cultures are obtained

Answer

Irrigation in triage followed by outpatient fixation

Answer

Immediate casting before antibiotics

Open tibial fracture — ABEM Board MCQ

A 24-year-old construction worker presents as triage level 2 with a grossly contaminated open tibia fracture after a crush injury. Distal pulses are present and pain is severe. Tetanus status is unknown. Which of the following is the most appropriate next step in management?