called to scene of 1 vehicle vs tree. Initial impression: no skid marks, moderate frontal damage, no air bag, steering wheel intact, 1 patient, driver restrained - flaccid in drivers seat, driver door won't open due to impact, no entrapment of patient beyond the damaged door. Fire and LE on scene. initial assessment: no witnesses Your partner takes c-spine driver moans weakly to loud verbal stimuli, does not open eyes. breathing is shallow and rapid 38/min breathe sounds are wet rales in all fields circulation is weak and thready at 133 b/min nrb 15l/min high priority - rapid transport patient medic alert bracelet: Cardiac history, allergy to HCTZ. no sample or opqrst available rapid trauma assessment reveals pms + (withdraws to painful) in all extremeties, eyes perrl, no signs of basilar skull fracture, no signs of dcapbtls or any obvious trauma (rapid trauma assessment is essentially negative except for a minor oozing laceration to the left cheek) baseline vitals 90/50, hr 155, breathing 35 o2 sat 80 extricate with a KED and long backboard. once the patient is loaded in the ambulance 2 large bore IVs place the patient on the monitor reveals ... multifocal pvcs and runs of paroxysmal vtach 8, 10 , 12 Oxygen saturation reads 75, patient is breathing 28 /min what do you do. call out your interventions once the ambulance starts moving. 15-20 minutes until the hospital. you can have 1 MFR/firefighter in the patient compartment with you.