If no distal pulse is felt following a suspected extremity fracture, EMTs should...

• A. Call medical control and wait
• B. Apply ice and elevation
• C. Place extremity into anatomical position and apply gentle traction along the axis of the extremity until distal pulses are regained and splint in place
• D. Immediate surgical reduction

Answer: (C)

When a suspected extremity fracture is accompanied by no distal pulse, the priority is to restore perfusion while keeping the limb stable for transport. Gently placing the extremity back toward its normal alignment and applying traction along the long axis can relieve deforming forces that may be compressing vessels. Once the limb is in approximate anatomical position, splint it to maintain that alignment and prevent further injury. Reassess circulation and neurovascular status after traction; if distal pulses return, continue immobilization and rapid transport. If pulses do not return or if pain, numbness, or pallor worsen, stop traction and seek medical control for further guidance. Ice and elevation do not promptly restore distal perfusion in this scenario, waiting for medical control delays needed care, and immediate surgical reduction is outside EMT scope.