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Once catastrophic hemorrhage is controlled with a tourniquet, rapid transport becomes the priority. Open femur fractures often involve massive blood loss and are associated with other internal injuries from high-energy trauma. Definitive care requires surgical intervention. Option A (traction splint) is contraindicated in open femur fractures or when a tourniquet is in place. Option B (dressing) is acceptable but should not delay transport when bleeding is controlled. Option D is dangerous; removing the tourniquet risks uncontrolled hemorrhage. The EMT must follow the principle: stop the bleed, support ABCs, and transport without delay. Shock management—oxygen, warmth, and rapid evacuation—is critical. Communication with the trauma center should include mechanism of injury, interventions performed, and patient status. Field time should be minimized, adhering to the “golden hour” principle for trauma patients.