A 45 year old man was driving a compact car and was involved in a motor vehicle crash colliding head on with another vehicle on the freeway. At the scene, he was conscious with GCS of 15. There was no external blood loss. Blood pressure was 110/60, P92, and RR 28. Oxygen was started, one IV line secured, and he was transported to hospital ER. On arrival he was experiencing severe chest and abdominal pain. Vital signs were BP 112/74, P96, RR 30. He had a large contusion over the sternum and upper abdomen.