You are on duty in the Emergency Department when 5 patients are brought in by...

The patient with the angulated thigh, hypotension relative to baseline, and tachycardia likely has a femoral shaft fracture with concealed hemorrhage. This poses an immediate risk of hypovolemic shock and requires urgent assessment and stabilization.

Toronto Notes 2023 – Emergency Medicine, “Trauma Triage and Prioritization”:

“Patients with long bone fractures, especially femoral fractures, are at high risk for hemorrhage and should be prioritized for stabilization and hemorrhage control.”

MCCQE1 Objectives (Surgery > 51-1: Trauma):

“Candidates must prioritize trauma patients based on signs of instability or risk of deterioration, such as tachycardia and occult bleeding.”