A 48-year-old gardener is driven in by friends after sustaining a chain saw inury to his left arm 10 minutes ago. He complains of severe pain, and blood is dripping from a towel that is wrapped around the patient's wrist. There is a large laceration over the wrist with active bleeding, and the hand distal to the injury is pale and absent of capillary refill. The patient is unable to extend the digits and sensation is absent in the third and fourth digits. The patient appears pale, cool and diaphoretic. Medications: none. Allergies: none. Last dT: 8 years ago PMH: none BP 96/60 Oral Temp 92.2 HR 110 RR 18 What is your triage priority?