You are working as an industrial EMT in the oilsands for a large petroleum company. You are called to a truck-mounted rig where an 18-year-old male has been caught in the cable spool on a service truck. Your response time to the scene will be approximately 45 minutes. You are driving a 4x4 Mobile Treatment Centre and your paramedic partner will be bringing the ambulance from the base camp. Her response time will be at least 60 minutes. Your backup is limited and air ambulance is only an option with ideal flying weather, as well as availability of helicopters in the area.
It is a bright winter day and the temperature is –30ºC. You know you have limited daylight available. When you arrive on scene the casualty is still caught by his right forearm in the cable spool. His co-workers have been keeping him warm with blankets and keep replacing the blankets with new ones warmed by a heater. The work crew says they should be able to have him untangled from the cable in less than five minutes. You see the man lying over the top of the cable spool with his right arm stretched out in front of him. His clothes have been partially pulled off of him. He is alert and oriented but having trouble breathing because of the way he is laying and may also have a chest injury. His right arm is obviously fractured because it is bent at an abnormal angle close to the mid-forearm with a thick cable entangled around his arm. The right radial pulse is absent and the distal end of that limb is cold. There was no loss of consciousness and no other obvious injuries.