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1.initial assessment
2.scene size up
3.rapid trauma survey
4.ITLS ongoing exam
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1.trauma
2.tenderness (pain on palpation)
3.transport (load and go)
4.temperature
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1.early CPR
2.early advance care
3.early access
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1.a decrease in death rates
2. better care being delivered
3.accomplishment team of interventions
4.ineffective team collaboration
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1.an adult respiratory rate greather than 20per  minute
2.a tidal volume of less than 400ml
3.an oxygen saturation greater than 94%
4.an end tidal carbon dioxide level less than 30 mmhg
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