Your patient is a 60-year-old female driver of a vehicle involved in a moderate-speed frontal collision. She was unrestrained, but airbags deployed. There is no damage to the windshield, but the bottom of the steering wheel ring is deformed. On your initial approach to the vehicle, an EMT is in the back seat with manual cervical spine stabilization. The patient is anxious and complaining of pain "in her legs." She appears pale, her skin is cool but dry, she as a thready radial pulse of 116, respirations of 24, and clear, equal bilateral breath sounds. Her abdomen is soft and nontender, and there is no pain or instability on assessment of the pelvis. Which of the following is the best management of this patient?
A) Oxygen, c-collar, placement of a seated-spinal immobilization device, extrication onto a long backboard, use the long board to immobilize the lower extremities, begin transport, start two large-bore IVs of lactated Ringer's solution, and request orders for analgesia.
B) Oxygen, c-collar, placement of a seated-spinal immobilization device, extrication onto a long backboard, apply bilateral traction splints, begin transport, start two large-bore IVs of lactated Ringer's solution, and request orders for analgesia.
C) Oxygen, c-collar, rapid extrication onto a long backboard, rapid secondary assessment, placement of bilateral traction splints, begin transport, and start two large-bore IVs of isotonic crystalloid solution.
D) Oxygen, c-collar, rapid extrication onto a long backboard, rapid secondary assessment, application of PASG, begin transport, and start two large-bore IVs of isotonic crystalloid solution.
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