A 32-year-old male is involved in a high-speed motor vehicle collision in a rural area. On scene, you find him supine with an open femur fracture, signs of pelvic instability, and vital signs indicating hemorrhagic shock (blood pressure 85/60 mm Hg, heart rate 120 bpm). The extrication scene is hazardous and resources are limited. Based on patient treatment and transport principles, what is the most appropriate series of interventions prior to transport?
