Final answer:
The patient with an altered mental status and a fractured femur should be stabilized, transported rapidly to the closest trauma center, and the center should be notified of the patient's condition.
Step-by-step explanation:
After arriving at a motor vehicle collision and assessing the situation, it is clear that the patient with an altered mental status and angulated left femur requires immediate attention. The closest trauma center being 45 minutes away, the next steps should focus on stabilizing the patient's condition for transport. This involves assessing ABCs (Airway, Breathing, and Circulation), applying C-spine precautions if a spinal injury is suspected, providing high-flow oxygen, controlling any severe bleeding, and immobilizing the fractured femur to prevent further injury. Once the patient is stabilized, rapid transport to the trauma center is necessary due to the severity of the injuries. It is vital to continually monitor the patient's vital signs and neurological status during transport and to notify the receiving trauma center of the patient's condition to prepare for immediate intervention upon arrival.