Vehicle extrication & complex highway incidents require collaboration, coordination, and integration of multiple agencies and personnel for a common mission. Lack of collaborative interaction can have a significant impact on patient outcomes. Not recognizing significant bleeding or performing extrication functions before treating for crush injury are just two examples of how lack of coordination, improper or untimely tactics can negatively impact mortality and morbidity. Vehicle extrication and complex highway incidents require collaboration, coordination, and integration of multiple agencies and personnel for a common mission. This program will discuss how the integration of Crew Resource Management (CRM) as part of the incident management system can improve effectiveness while reducing conflict and errors towards the improvement of overall incident performance. This program will discuss the effective integration of CRM at extrications. This program details the priorities of patient care and extrication in all phases of extrication and complex highway incidents. Lack of coordination and poor leadership, not the tactics or performance of the personnel that causes an extrication to become chaotic and problematic. It’s how the incident is managed. How well these agencies and personalities integrate and work in a cooperative manner will impact the outcome of mortality and morbidity at these types of incidents. This program will discuss in detail how the five components of CRM, (teamwork, communication, situational awareness, decision making and task allocation) integrate into ICS, as well as task performance towards improved incident efficiency and effectiveness. CRM has been proven to be effective in Pit Crew CPR. CRM Can also improve extrication outcomes.