Paramedics with the St. Charles County (Mo.) Ambulance District and fire/rescue personnel from the Wentzville Fire Protection District provide care to a young couple who were on a motorcycle that collided with a brick wall at high speed. Both riders suffered multiple fractures, including open femur fractures. Paramedics couldn’t detect a distal pulse on the male patient’s left leg and repositioned it until they regained a pulse. They dressed the female patient’s open femur wound and carefully repositioned her leg while monitoring its distal pulse. Both patients were flown to a Level 1 trauma center in St. Louis.