Consider leaving the patient on the ambulance scoop stretcher if the MTC transfer is imminent. SAS to consider using the same crew for onward transfer.
<C> Treat with pressure / dressing / bandage / tourniquets / haemostatics.
A Secure Airway.
B If indicated, decompress the chest with thoracostomy and/or intercostals drainage (using transport drains rather than underwater seal bottles if possible and available.
C Secure and tape IV access x2.
Do not waste time / delay transfer with arterial lines. Pelvic Binder as indicated.
1g TXA if indicated.
Apply traction to femoral shaft fractures (use Kendrick splints as available).
H haemostatic resuscitation +/- Major Haemorrhage protocol as indicated.
D Prevent secondary brain injury.
E Use a Bair Hugger blanket or similar if hypothermic or shocked. Immobilise / reduce fractures / dislocations.