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Scenario:
A 22 year old motorcyclist is hit by an oncoming lorry on the 'national highway'. He is making 'gurgling' noises, tachypnoeic and tachycardic, He has a very deformed right arm and right leg. His radial pulse is weak but palpable. He is withdrawing to pain. The nearest facility for poly-trauma is approximately 80 minutes away (if the roads are clear!!!)

What kind of pre-hospital care/system should we have to ensure optimum treatment for this patient?
Do you feel a doctor should be sent out as part of the EMS team?
Is it better just to 'scoop and run' to the nearest health facility for initial stabilisation and then subsequently transfer to another centre for definitive care?
Would you deploy a helicopter to retrieve the patient?
I am sure there are hundreds of other options.... but what is ideal and still feasible?

(sorry ...too many questions!!!)