Prompt transport to an appropriate medical facility shall be the prime consideration in the treatment & transportation of traumatized patients. The EMS System expectation is that scene time will be less than 10 minutes unless prolonged by extrication.

1. Perform patient assessment and ABC's (Perform complete primary patient survey prior to transport, unless patient condition indicates differently. Secondary assessments can be completed en route).
2. Immobilize cervical spine following primary survey if appropriate based upon patient condition and/or mechanism of injury.
3. Administer high-flow oxygen via a device to insure adequate patient oxygenation. Apply pulse oximetry device and record reading whenever appropriate and time permits.
4. Recognize and respond promptly to life threatening injuries.
5. Recognize and treat shcok.
6. Dress wounds per protocol and as circumstances allow.
7. Immobilize and splint possible fractures prior to movement unless there is an urgent reason to remove patient rapidly from a dangerous situation or patient's condition requires rapid transport.
8. If patient is hypotensive and other injuries do not prevent, place patient in trendelenburg position.
9. Unless transporation will be delayed as a result of extrication or other circumstances, IV therapy and other ILS/ALS procedures should be accomplished enroute to the medical facility.
10. Monitor vital signs in accordance with S.O.P. protocol.
11. Apply PASG as appropriate for treatment of shock.
12. Request ALS Intercept if patient present in unstable condition.

INTERMEDIATE LIFE SUPPORT

1. If vital signs are significantly abnormal or unstable, initiate IV access using an isotonic solution. Consider multiple IV's based on patient condition and MOI.
2. Refer to SHOCK protocol as necessary.
3. Keep in mind that blood cannot be infused with L.R. At least one IV access should have NS running with a large-bore cannula if possible.

ADVANCED LIFE SUPPORT

1. If patient's overall condition is unstable, attach EMG monitor.
2. Treat specific conditions like, tension pneumothorax, gross hypovolemia, shock, obstructed airway, respiratory and cardiac arrest in accordance with condition specific protocols.
3. For isolated, non-life threatening trauma, refer to PAIN MANAGEMENT protocol.