Added tag for NBME form 11, card directly answers the question, see below:
A 17-year-old boy is brought to the emergency department 30 minutes after he was thrown through a
window during an altercation. He has no history of serious illness and takes no medications. He is alert and
fully oriented. He reports moderate pain in his right arm and hand. His pulse is 110/min, respirations are
22/min, and blood pressure is 110/70 mm Hg. Pulse oximetry on 2 L/min of oxygen by nasal cannula shows
an oxygen saturation of 98%. Examination shows superficial abrasions over the right side of the face.
A 4 × 4-cm glass shard protrudes from the right upper extremity 2 cm proximal to the medial epicondyle;
the extremity is cool and pale, and radial and ulnar pulses are not palpable. Which of the following is the
most appropriate next step in management?
Answer: Operative wound exploration