Which of the following is a critical step in treating open fractures?

Immobilization of the fracture is a critical step in treating open fractures because it helps to stabilize the bone and surrounding tissues, reducing the risk of further injury and complications. By keeping the fracture site still, immobilization aids in preventing movement that could exacerbate the injury, potentially leading to increased pain or additional damage to muscles, blood vessels, or nerves.

Furthermore, immobilization is essential for minimizing the risk of infection. Open fractures expose the underlying bone and tissues to external contaminants, so stabilizing the fracture can help protect the area while transport to a medical facility occurs. It also plays a role in managing the patient's pain and discomfort during transportation.

Immediate surgery, while necessary for many open fractures, is not considered a critical step in the initial field management. Instead, it is the stabilization and protection of the injury that takes precedence before surgical interventions can be planned. Application of a cold compress may help with swelling and pain management but does not address the critical nature of stabilizing the fracture itself. Elevation of the limb can assist with swelling, but again, it is not as crucial as effective immobilization in the immediate management of an open fracture.