NREMT Paramedic Practice

What distinguishes open vault fractures from other types of skull fractures?

1. They do not involve any lacerations

2. They create a direct opening to brain tissue

3. They only damage the outer layer of the skull

4. They result in no associated bleeding

The correct answer is: They create a direct opening to brain tissue

Open vault fractures are characterized by creating a direct opening to brain tissue. This type of fracture involves a break in the skull that penetrates through the outer skull layers and exposes the underlying brain to the external environment. This exposure significantly increases the risk of infection and intracranial complications, as pathogens can enter through the fracture site. In contrast, the other types of fractures, such as closed vault fractures, do not open up the skull to the environment and therefore do not directly expose the brain. This differentiates them from open vault fractures, highlighting the severity and potential consequences associated with the latter. Open fractures are often accompanied by significant risk factors, including bleeding, and can involve damage beyond just the outer layer of the skull, unlike what is suggested by other options. Additionally, while some lacerations may not be present in all open fractures, the direct connection to brain tissue remains a critical identifying factor.