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This research explores how a wide range of automobile crash, emergency responder, hospital, and trauma information could be useful to emergency medical practitioners for making decisions about automobile crash victims. We use a framework from prior research to consider, devise and examine emergency medical practitioner use of information systems for improving emergency response services and outcomes. This paper first provides an overview of clinical decision support systems focused on car crash emergency and trauma response. Concepts are grounded in a case study investigation conducted in Minnesota at the State and local level (Mayo Clinic). Operational data from 911 communications, ambulance response, and trauma data systems were linked together to demonstrate a data integration "proof of concept" to emergency medical practitioners. Interviews and focus groups discussions were then conducted to discuss the current and potential value of integrating inter-organizational data for real-time decision support. Analysis across these various methods provided a multi-layered understanding which led to a descriptive architecture for a crash trauma information system.