Major Trauma

Natalie May continues her reflections on a year with Sydney HEMS, focusing on paediatric retrieval, drowning and airway care. These personal clinical lessons explore equipment, communication and the compromises involved in delivering critical care outside the hospital.

Moving a critically ill patient from the ED can be a high-risk part of their care. Natalie May and Simon Carley’s podcast notes explore patient preparation, equipment, team selection and handover, with contingency plans for delays, deterioration and airway problems.

What can UK registry data tell us about traumatic cardiac arrest? This 2016 appraisal examines survival and injury patterns in TARN, while explaining why observational associations cannot establish which interventions work and why different causes may require different approaches.

Simon Carley introduces a 2016 paper he co-authored on impact brain apnoea, drawing on observations from motorsport and prehospital care. The post also honours John Hinds’ contribution to the work and reflects on how clinicians’ shared experiences can prompt research questions.

Does hypertonic saline offer better outcomes than mannitol after traumatic brain injury? This 2016 appraisal explores the limited comparative evidence, distinguishes changes in intracranial pressure from outcomes that matter to patients and considers the uncertainty surrounding temporary treatment before definitive care.

Natalie May and Iain Beardsell review the opening day of the 2015 London Trauma Conference in this report and podcast. Highlights include older trauma patients, human factors, brain and spinal injury, mass-casualty care and why effective systems matter more than any single intervention.