I'm looking at this from both perspectives, the medics bringing the kid in, and the ED staff that will be working him up. The top priorities for this patient (whether you're in or out of the hospital) are: IVs and fluid for shock, O2 and potential assistance with a bvm and consider an expedient intubation, RSI would be ideal. DON'T sedate/paralyze this guy before you get a good neuro exam. "Unresponsive" is too vague. Get a good GCS and try to determine if he has any extremity motor/sensory deficits. From the medics' perspective, transport time From the ED perspective, after I assure his ABCs and get him on my monitors, get him off the backboard if I can, I'll start shooting some films and get my FAST to determine the extent of any internal injuries and draw my baseline labs and blood gases. I'll also want that neuro exam to determine any extremity/spinal injuries and figure out if this guy needs to go to surgery or not. Lemme know what you think of the approach.