> For the complete documentation index, see [llms.txt](https://handbook.teddwa.xyz/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://handbook.teddwa.xyz/broken-limbs.md).

# Broken limbs

Assess suspected fractures, protect circulation, immobilize safely, and transport.

### Immediate actions

1. Complete the primary assessment (ABCs) and manage life threats first.
2. Expose the injury enough to assess deformity, swelling, bleeding, and open wounds.
3. Control major bleeding and cover open fractures with a sterile dressing.

Do not move the limb unnecessarily. Do not attempt to push exposed bone back into the wound.

### Check distal function

Assess and document circulation, sensation, and movement below the injury before and after immobilization. Check skin color, warmth, capillary refill, and distal pulses when accessible.

{% hint style="danger" %}
Treat absent pulses, worsening pain, numbness, paralysis, pale or cool skin, and uncontrolled bleeding as urgent threats.
{% endhint %}

### Immobilize the injury

Immobilize the injury in the position found. Support the joint above and below the suspected fracture.

Pad rigid splints and secure them without restricting circulation. Reassess distal function after every adjustment.

### BLS and ALS care

BLS should provide manual stabilization, splinting, cold packs over a barrier when appropriate, and frequent neurovascular reassessment.

ALS should treat severe pain with fentanyl, morphine, or ketamine when appropriate. Establish IV or IO access for major trauma, severe pain, or suspected shock.

Use a traction splint for an isolated mid shaft femur fracture. Do not use it for pelvic, knee, lower leg, ankle, or multi system trauma.

### Select a guide

* [Broken arms, wrists, and hands](/broken-limbs/broken-arms-wrists-and-hands.md)
* [Broken legs, ankles, and feet](/broken-limbs/broken-legs-ankles-and-feet.md)

{% hint style="warning" %}
Suspect spine or pelvic injury after significant trauma. Minimize movement and use spinal precautions when indicated.
{% endhint %}


---

# Agent Instructions
This documentation is published with GitBook. GitBook is the documentation platform designed so that both humans and AI agents can read, navigate, and reason over technical content effectively. Learn more at gitbook.com.

## Querying This Documentation
If you need additional information that is not directly available in this page, you can query the documentation dynamically by asking a question.

Perform an HTTP GET request on the current page URL with the `ask` query parameter, and the optional `goal` query parameter:

```
GET https://handbook.teddwa.xyz/broken-limbs.md?ask=<question>&goal=<endgoal>
```

`ask` is the immediate question: it should be specific, self-contained, and written in natural language.
`goal` is optional and describes the broader end goal you are ultimately trying to accomplish on behalf of the user. GitBook uses it to tailor the answer towards what is most useful for that goal.

The response will contain a direct answer to the question and relevant excerpts and sources from the documentation.

Use this mechanism when the answer is not explicitly present in the current page, you need clarification or additional context, or you want to retrieve related documentation sections.