The ABCs (airway, breathing, and circulation) are essential. Unconscious patients require rapid and definitive airway control. The trachea should be intubated in a rapid-sequence fashion. Establish numerous large-gauge sites of intravenous access, using either short 14-or 16-G catheters peripherally or 9 Fr introducers into the central circulation. Quickly bolus the patient with at least 2 L of balanced crystalloid solution. Failure to respond indicates a need for blood. If crossmatched blood is unavailable, transfuse O-negative or type-specific red blood cells. If more than 2 units of O-negative red bloods cells is given, continue administering O-negative blood. Establish an arterial catheter for continuous monitoring and blood analysis (arterial blood gases, hematocrit, platelet count, coagulation profiles, and blood chemistries).
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