Signs and symptoms may include any or all of the following: disoriented, weak, tachycardia, systolic < 90, weak or absent radial pulses, cool and clammy skin, diaphoresis, pallor, nausea and vomiting, rapid and shallow respiration, diminished LOC and have significant injury, mechanism of injury or illness.

EMPHASIS ON PATIENT CARE

Maintain adequate perfusion, oxygenation.

FIRST RESPONDER AND BASIC PRE-HOSPITAL MANAGEMENT

1. Initial Management - Assess airway, breathing and circulation and manage as indicated.
2. Transport the patient without delay to an appropriate medical facility
3. Focused H&P - History, physical exam, vital signs. BGL

• Obtain history of incident including:
  • Possible underlying medical causes.
  • Speed.
  • Seat belts.
  • Caliber of firearm, distance.
  • Length of knife or object.
  • Blunt or penetrating trauma.

INTERMEDIATE and PARAMEDIC PRE-HOSPITAL MANAGEMENT

4. En-route, initiate two large bore IVs of an isotonic solution with blood tubing administration set if available and infuse at a flow rate to maintain adequate vital signs.