37.1. As a result of a road traffic accident, a motorcyclist has a visible wound on the right shin with a bone fragment protruding. What is the first pre-medical aid?
UAУнаслідок ДТП у мотоцикліста на правій гомілці видима рана, з якої виступає уламок кістки. Яка перша домедична допомога?
This exam question from the Traffic Rules of Ukraine concerns road safety after an accident and the ability to provide pre-medical assistance to a victim. In real traffic accidents, the first minutes most often affect the outcome of the injury: an open fracture is dangerous not only because of pain and bleeding, but also due to a high risk of infection, so the correct sequence of actions by the driver or witness is critically important for preserving health and life.
This task is included in the theoretical traffic rules exam as a test of knowledge of the section on the driver's duties in the event of an accident (point 2.10 of the Traffic Rules) and understanding the requirement to "take possible measures to provide pre-medical assistance." The situation involves signs of an open shin fracture, when a bone fragment is visible: the priority is to protect the wound with a sterile (or clean) dressing and ensure transport immobilization by fixing the joints above and below the fracture site. It is fundamentally important not to attempt to reposition the bone fragment or "straighten" the leg by force, so as not to worsen tissue injury and bleeding.
The explanation of the answer options comes down to the quality of fixation and prevention of complications. The correct approach involves dressing the wound, ensuring reliable immobilization of the limb (for the shin, this is the knee and ankle joints), and transporting in a position that does not increase pain or force movement of the fracture area. The alternative with a roller and painkillers does not solve the main task of pre-medical care for an open fracture: the roller does not provide immobilization, and the absence of a dressing increases the risk of infection, so this option is insufficient and potentially dangerous.
Clause 1.10 (the term “Road Traffic Accident”)
Road traffic accident — an event that occurred during the movement of a vehicle, as a result of which people were killed or injured, or material damage was caused.
Clause 2.10 (Driver’s duties in case of involvement in a road traffic accident — providing assistance to victims)
In case of involvement in a road traffic accident, the driver is obliged to: take all possible measures to provide first aid to the victims, call (notify) emergency medical services, and if this is not possible — transport the victims to the nearest medical facility using their own vehicle, after first recording the location of the accident traces as well as the position of the vehicle after it has stopped; at the medical facility, report their surname and the registration number of the vehicle (presenting a personal identification document or driver’s license and the vehicle registration document) and return to the scene of the road traffic accident.
This clause of the Traffic Rules checks the obligation of the driver (and other involved participants) specifically to provide first aid and to organize the fastest possible receipt of medical care/transportation to a healthcare facility; specific first aid techniques (sterile dressing for an open fracture, immobilization with fixation of joints above and below the fracture site, transportation in a comfortable position) are the practical content of fulfilling the requirement “to take all possible measures to provide first aid.”
Therefore, the correct answer is: “Apply a sterile dressing to the wound, immobilize the joints above and below the fracture site, and transport the victim in a comfortable position for them,” given that according to the definition in the Traffic Rules, a driver involved in a road traffic accident is obliged to take all possible measures to provide first aid to the victims and ensure they receive medical care as quickly as possible (call EMS or transport to the nearest medical facility).
In a situation where, after a traffic accident, there is a wound on the shin and a bone fragment is visible, these are signs of an open fracture. Such an injury is dangerous not only due to pain and bleeding, but also because of the risk of wound infection, so the first actions should be aimed at protecting the wound and preventing further damage to the limb.
First of all, the wound should be covered with a sterile dressing. This is done to isolate the injury site from dirt and microorganisms. It is important to understand the key rule: you must not try to "set" the bone back or straighten the leg by force. Such actions can increase bleeding, worsen tissue injury, and deteriorate the victim's condition.
Next, it is necessary to immobilize the leg, that is, to provide transport immobilization. To do this, the joints above and below the fracture site are fixed (for the shin, these are the knee and ankle joints). The point is that the bone itself should not move in the fracture area during carrying or transportation; otherwise, the fragments may further injure soft tissues and blood vessels. Simply placing a roller or elevating the leg is not enough, as this does not provide reliable fixation.
After applying the dressing and immobilizing the limb, the victim should be transported in the position that is most comfortable for them and does not increase pain. During transportation, the main task of the driver or witness is not to "fix" the injury, but to deliver the person to medical professionals as carefully as possible without unnecessary movement of the injured leg.
Therefore, the correct answer is "Apply a sterile dressing to the wound, immobilize the joints above and below the fracture site, and transport the victim in a position comfortable for them," since with an open fracture, it is essential first to protect the wound from infection and ensure the limb's immobility, without attempting to set the bone fragments.