EMTs and paramedics from the Oklahoma City Fire Department (OCFD) and Emergency Medical Services Authority (EMSA) treat a fall victim at a construction site. The worker was laying metal roofing when a gust of wind blew him and the roofing off the structure. He fell 25 feet to the ground and sustained a significant closed head injury and bilateral tension pneumothorax. The EMSA and OCFD crews worked together to render BLS/ALS care to the patient and carefully immobilize him before transport. The patient received bilateral chest needle decompression and was intubated en route to the trauma center, where he survived his injuries and was discharged without neurological deficit.