If you encounter someone with an exposed fracture (where the bone is sticking out through the skin), it’s critical to act quickly and calmly to minimize pain, prevent infection, and reduce further injury. Here are the steps to take:

1. Ensure your safety: Before approaching the person, ensure the scene is safe from any ongoing hazards that could cause harm to you or the injured person.
2. Call for help: Call emergency services (911 or your local emergency number) immediately. Explain the situation clearly so that they can dispatch appropriate medical personnel and equipment.
3. Control bleeding: If there is bleeding from the wound, apply direct pressure around the wound using a clean cloth or sterile dressing. Do not press directly on the bone or attempt to reposition it. Use a clean cloth or dressing to cover the exposed bone to protect it from contamination and further injury.
4. Immobilize the injured limb: If possible, gently support the injured limb in the position you find it using towels, pillows, or clothing to prevent movement. Avoid moving the limb unnecessarily, as this can cause further damage and increase pain.
5. Do not try to realign the bone: Do not attempt to push the bone back into place. This should only be done by trained medical professionals in a controlled environment to avoid causing additional damage or complications.
6. Keep the person calm: Reassure the person and keep them as calm and still as possible. Shock can be a concern with severe injuries, so help them stay warm and comfortable while awaiting medical help.
7. Monitor for signs of shock: Watch for signs of shock, such as pale or clammy skin, rapid heartbeat, shallow breathing, or dizziness. If present, lay the person down with their legs elevated slightly (unless it causes pain or further injury) and cover them with a blanket or jacket to keep them warm.
8. Provide comfort: Stay with the person and provide comfort and reassurance until medical help arrives. Talk to them calmly and encourage them to focus on their breathing.
9. Do not give them anything to eat or drink: In case surgery is necessary, the person should not eat or drink anything. This helps to prevent complications related to anesthesia and surgery.

Remember, managing an exposed fracture requires urgent medical attention. Do not attempt to treat the injury beyond providing basic first aid and immobilization. Professional medical care is essential to properly assess the injury, clean and dress the wound, and provide appropriate treatment to minimize complications and promote healing.