Primary Survey

Airway:	Intubated and ventilated
Breathing:	Trachea central. Equal, moderate air entry. Bilateral chest tubes in place - drained 200 mls initially.
Circulation:	Heart rate 140, BP 40/0. Already given 1 litre crystalloid solution.
Dysfunction:	GCS 14 on paramedic arrival, now 5. Pupils equal. No external signs of head injury
Exposure:	No other obvious external injury