A 34 year old male has a fractured left elbow that is cyanotic and pulseless. What should you do?

In the scenario presented, the patient is experiencing a fractured left elbow that is cyanotic and pulseless, which indicates a possible compromised circulation due to the injury. The best course of action is to align the extremity with gentle traction until resistance is met. This technique can help to realign any displaced bone fragments and potentially relieve pressure on the blood vessels that might be causing the pulselessness and cyanosis.

By gently applying traction, you are attempting to restore blood flow to the area, which is critical in maintaining the limb's viability. It's important to stop the traction once resistance is met to avoid causing further injury.

Stabilizing the elbow in a sling and swathe or immobilizing with a traction splint does not directly address the issue of compromised circulation, as those methods could maintain the current position that might be contributing to the vascular issues. Similarly, immobilizing the arm as it was found does not apply any corrective measures to potentially alleviate the circulatory compromise. Instead, aligning with gentle traction provides a potential therapeutic action to improve the patient's condition.