Inclusion Criteria:  ① airway obstruction, need tracheal intubation or intubation;② breathing stop, respiratory distress or significant slowing down;③ circulatory system shows various shock signs④GCS≤8;⑤ body table visible head, torso, chest open injury or yoke chest  Exclusion Criteria:  All patients who stop the rescue room trauma evaluation and treatment midway through hospital transfer and automatic discharge