Considerable controversy exists regarding the prehospital management of critically injured patients by EMS personnel. A "scoop and run" approach may neglect key issues, such as a compromised airway, while prolonged attempts at resuscitation in the field simply cannot stabilize a patient in need of operative intervention. Few prospective, randomized clinical trials exist that address those advanced life support (ALS) interventions performed in the prehospital setting that improve patient outcome.