In the severely injured patient, time is of the essence. However, caution must be exercised in

stabilizing the cervical spine while executing a rapid extrication. Initial assessment should be

performed on the scene. All other procedures must be performed en route to an appropriate

facility. An EMS provider transport service must be contacted for response to provide additional

treatment and transfer to an appropriate facility.

A. Call for EMS transport, if not already activated.

B. Maintain airway:

1. Stabilize c-spine and open airway using jaw thrust technique.

2. Insert oral or nasopharyngeal airway as needed.

C. Breathing:

1. If adequate, administer oxygen 15 LPM via non-rebreathing mask.

2. If inadequate, ventilate with oxygen via mouth to mask.

D. Circulation:

1. Control bleeding.

2. Assess perfusion status. (Note skin color, temperature, and capillary refill.)

E. Treatment:

1. Immobilize patient on long spine board with cervical collar.

2. Monitor vital signs.

F. Transfer patient to the transporting EMS provider.