How to Treat an Open Fracture in the Wilderness: Step-by-Step Guide for Outdoor Emergencies | PrepEM Wild
Open Fractures in the Outdoors: A Simple, Safe Game Plan (and the Gear That Helps)
An open fracture is a broken bone with a cut in the skin that connects to the break. These injuries have a high infection risk and can lead to serious problems if not handled well. This guide gives you a clear, step-by-step plan you can use in the field—and shows how PrepEM Wild’s Essentials Pro Kit (with WoundClot® gauze and the Snakestaff Systems ETQ™ Gen-2 tourniquet) fits into that plan. Subscribe on www.prepemwild.com with your email to stay updated on essential skills for the outdoors.
What is an “open fracture”—and why it’s serious
Open fracture = broken bone + a skin wound that reaches the bone. Because the skin barrier is broken, dirt and germs can reach the bone easily, raising the chance of a deep infection (bone infection = osteomyelitis). That’s why open fractures get urgent attention in hospitals. 
Doctors often describe open fractures using the Gustilo-Anderson scale (Type I = small skin wound; Type III = big wound with heavy damage). Higher types carry higher infection and complication risk. 
Why the backcountry is riskier: delays to medical care, environmental contamination (dirt, water, plant material), cold exposure, and limited supplies—all of which raise the odds of infection and other complications. Earlier care is better care. Hospitals push for antibiotics quickly because delays are linked with higher infection rates. 
Field priorities
Think “Stop bleeding → Protect the wound → Stabilize → Evacuate.”
1) Control life-threatening bleeding first
• Direct pressure with clean gauze or cloth.
• If bleeding is heavy and won’t stop fast with pressure, use a tourniquet high and tight on the limb. (Our go-to is the compact, field-proven Snakestaff Systems ETQ™ Gen-2 in the Essentials Pro Kit.)
• For bleeding inside a wound you can’t tourniquet, pack with hemostatic gauze (we stock WoundClot® in the Pro Kit) and hold firm pressure for several minutes.
These steps are standard wilderness best-practice and save lives. 
2) Expose and cover—don’t “dig”
• Cut away clothing so you can see the injury.
• Do not try to push bones back in and don’t “fish” inside the wound.
• Lightly rinse obvious dirt if you can do so safely (more on irrigation below), then cover with a clean, non-stick dressing and secure it. Keep it loose enough to allow drainage.
Important: PrepEM Wild kits do not include sterile saline or irrigation syringes. If you’re carrying water, clean potable water is acceptable for gentle wound rinsing in the field; avoid additives. Use enough to float out visible dirt if you can do so without delaying evacuation. 
3) Splint for comfort and to prevent further damage
• Immobilize the limb above and below the break with a padded rigid or moldable splint (e.g., SAM-style splint) and wrap to keep things from moving. This limits pain and prevents bone ends from tearing more tissue. (Re-check circulation by feeling for pulses, feeling, and movement in fingers/toes after splinting.) 
4) Watch for compartment syndrome (emergency)
If pain is severe and worsening, especially worse with gentle stretch of the muscles, or the limb feels tense, get moving on evacuation—this can threaten the limb. 
5) Evacuate promptly
Open fractures need hospital care for antibiotics, imaging, and surgical cleaning (called debridement). Early treatment lowers infection risk and improves outcomes. 
Common mistakes (and how to avoid them)
• Waiting on bleeding control. Don’t. Use pressure, WoundClot® gauze for wound packing, or a Snakestaff ETQ™ Gen-2 tourniquet early if needed. 
• Closing the wound in the field. Don’t seal dirty wounds; you can trap contamination. Cover and protect instead. 
• Over-handling the injury. Pulling at bone ends or probing the wound introduces germs and damages tissue.
• Skipping splinting. Motion increases pain and tissue injury.
• Missing compartment syndrome. Pain out of proportion and pain with passive stretch = red flags. Evacuate. 
• Delaying evacuation. Open fractures are time-sensitive; hospital antibiotics given earlier reduce infection risk. 
Where the PrepEM Wild Essentials Pro Kit fits in
Built by ER docs for the backcountry, our Pro Kit focuses on the skills that save lives before rescue arrives:
• Bleeding control: WoundClot® hemostatic gauze for wound packing; Snakestaff Systems ETQ™ Gen-2 tourniquet for rapid limb hemorrhage control.
• Protection & stabilization: Dressings, wraps, and tools to splint and secure.
• Compact, organized layout to move fast when seconds matter.
We keep kits lean and effective for real-world carry—so we don’t include heavy irrigation bottles or sterile saline. If you want to rinse visible dirt, plan to carry your own potable water and a small squeeze bottle or hydration bladder you can control. 
Ready to level up? Grab the Essentials Pro Kit and subscribe to PrepEM Wild emails for straight-talk guides, drills, and discounts—designed for normal outdoors people, not hospital staff.
Learn more about the PrepEM Wild Essentials Pro Kit designed for backcountry bleeding control.
Quick stats (why speed matters)
• Open fractures carry significant infection risk; the more severe the soft-tissue damage, the higher the risk. 
• Faster hospital antibiotics are associated with lower infection rates after open fractures. • High-pressure irrigation and proper surgical cleaning in the hospital reduce bacterial burden; in the field, potable water is acceptable if you choose to rinse visible debris. 
Simple step-by-step checklist (print or save)
1. Scene safe → gloves which all our kits include
2. Big bleed? → Direct pressure → If not controlled, apply Snakestaff ETQ™ Gen-2 tourniquet high and tight.
3. Expose injury → cut clothing → do not push bone back in.
4. Optional rinse if safe and quick → use clean drinking water to float off visible dirt (no additives). 
5. Pack oozing wound with WoundClot® gauze; hold firm pressure for several minutes. 
6. Cover with clean, non-stick dressing; pad.
7. Splint the limb.
8. Re-check circulation/feeling/motion in fingers/toes. Check pulses
9. Watch for red flags: worsening pain, pain with gentle stretch, numbness, pale or very tight limb.
10. Evacuate promptly to the nearest emergency department.
Q: How do I know it’s an open fracture?
A: If there’s a broken bone and any skin wound that connects to it (even if you don’t see bone), treat it as an open fracture. Infection risk is high; cover and evacuate. 
Q: Should I rinse the wound in the field?
A: If you can do it quickly and safely, a gentle rinse with clean drinking water to remove visible dirt is reasonable. Don’t add chemicals. Don’t delay evacuation to rinse. 
Q: Do I close the wound with tape or glue?
A: No. Closing a contaminated wound can trap germs. Cover and protect; let the hospital clean and decide closure. 
Q: When should I use a tourniquet?
A: If direct pressure doesn’t rapidly control heavy limb bleeding, apply a tourniquet. The Snakestaff ETQ™ Gen-2 is compact and made for fast application. 
Q: What signs mean “get moving now”?
A: Severe, worsening pain, especially worse with gentle stretch, a very tight/tense limb, or numbness/pallor—these can signal compartment syndrome and need urgent care. 
If you spend time off-grid, be the asset, not the liability.
• Pick up the PrepEM Wild Essentials Pro Kit (with WoundClot® and Snakestaff ETQ™ Gen-2) so you’re ready for real-world injuries.
• Subscribe to our emails for short, plain-English guides (like this one), drills you can practice at home, and early access to new posts and gear.
Stay Prepared. Stay Wild.
