It is important that we recognize that we have seen a reduction in the number of deaths from trauma. That’s a great thing of course, but we should not be complacent. It’s also worth looking at where and how patients die. The key graph from the editorial is shown below and is based on data from the Royal London Hospital. The data seems to be suggesting that changes to how we manage trauma have altered where, and perhaps why people die. Overall we are getting better at the resuscitation phases of trauma management. Prehospital care improvements, such as the use of prehospital blood, has led to an increase in the number of patients reaching hospital alive. Improvements in our resuscitation practice, such as TXA and the regionalisation of trauma seem to suggest a significant difference in prehopsital deaths, but more people arriving in hospital alive means that a greater number of patients die in the first few hours. Improved surgical techniques and better surgical practice have resulted in more patients reaching the ICU alive with fewer patients who survive the first 3 hours dying on the first day and making it to the ICU.

Read More