What should be the primary concern for a patient with an open leg injury and severe pain?

The primary concern for a patient with an open leg injury and severe pain is controlling any external bleeding. This is critical because significant blood loss can rapidly lead to hypovolemic shock, which is a life-threatening condition. When a leg injury is open, it exposes the underlying tissues and blood vessels to the outside environment, increasing the risk of bleeding. Controlling this bleeding promptly is essential to stabilize the patient and prevent complications.

While other options like administering high-flow oxygen, covering the wound, and assessing distal pulses are important, they do not take precedence over immediate hemorrhage control. Administering oxygen could be necessary depending on the patient’s overall condition after controlling bleeding. Covering the wound is vital for preventing infection and protecting the area, but it should come after ensuring that any bleeding is managed. Assessing pulses is critical for evaluating limb perfusion but is secondary to stopping the bleeding. Therefore, controlling external bleeding is the most urgent intervention in this scenario.