1. SCENE SIZE-UP AND PPE: Confirm no immediate hazards such as fuel leaks or active traffic before approaching. Don nitrile gloves before making patient contact, without exception.

2. PATIENT ACCESS AND EXPOSURE: If vehicle doors are inoperable, use the Life Saver Hammer to breach the rear or side window farthest from the patient. Announce "Breaking glass" before striking, then use utility shears to cut away clothing and fully expose all suspected injury sites.

3. PRIMARY SURVEY AND LIFE THREAT CONTROL: Conduct an immediate assessment of airway, breathing, and circulation. Address catastrophic extremity hemorrhage first by applying the CAT tourniquet high and tight, or use the trauma dressing for wounds not amenable to tourniquet placement.

4. DIAGNOSTIC ASSESSMENT: Check pupils with the penlight and pupil gauge to evaluate neurological status. Apply the pulse oximeter for continuous SpO2 monitoring and obtain a manual BP reading using the sphygmomanometer and stethoscope.

5. AIRWAY INTERVENTION IF INDICATED: If the patient is unresponsive and without a gag reflex, size and insert an OPA by measuring from the corner of the mouth to the angle of the jaw. Do not insert an OPA in any patient with an intact gag reflex.

6. FRACTURE IMMOBILIZATION: If a fracture or dislocation is suspected, form the 36-inch splint roll to conform to the injury. Check pulse, motor function, and sensation distal to the injury both before and after splinting, then secure with self-adherent or elastic bandage.

7. WOUND DRESSING: Cover open wounds with appropriately sized sterile gauze pads or rolls and secure with cloth or waterproof tape. For burns, apply petroleum gauze directly to the wound bed to prevent adherence, cover with the 60x90-inch burn sheet for large surface area involvement, and apply Xero Burn Gel only for minor, localized burns.

8. MEDICATION ADMINISTRATION PER PROTOCOL: If hypoglycemia is suspected and the patient is conscious and able to manage their own airway, administer glucose gel per local protocol. Do not administer oral glucose to any patient with a compromised airway or altered level of consciousness.

9. PATIENT PACKAGING AND ENVIRONMENTAL PROTECTION: Once extricated, immediately wrap the patient in the Mylar blanket to reflect body heat and prevent hypothermia, particularly in wet or cold environmental conditions.

10. CONTINUOUS MONITORING AND TRANSFER OF CARE: Reassess all interventions and monitor vital signs continuously until transfer of care to the transporting EMS unit. Communicate tourniquet application time clearly during handoff and document it in writing.

11. POST-DEPLOYMENT RESUPPLY: After every operational use, conduct a full inventory of the response bag and restock all consumed items before returning the bag to service. Clean all non-disposable equipment including the BP cuff, stethoscope, and shears per infectious disease control protocols, and log all consumed supplies to inform the next resupply order.