Signs/Symptoms: Cool skin, poor capillary refill, tachycardia, weak peripheral pulses, low BP, altered mental status.
1. Perform primary survey. Perform secondary survey while obtaining history.
2. If trauma, immobilize head and spine.
3. Begin oxygen therapy.
4. Begin transport prior to any other ALS intervention. Position in Trendelenburg if hypotensive.
5. Apply ECG leads after quick-look to establish rhythm.
6. Start IV Normal Saline using Burette infusion set. If IV not possible, may attempt IO access (if authorized). Contact a medical control physician for infusion rate; recommended initial bolus = 20 cc/kg (10 cc/lb.)