UK & Ireland Major Trauma Haemorrhage: What Now? What Next? 12th & 13th March, Wellcome Trust, London & online Register for free here: eventbrite.co.uk/e/uk-major-… Critical bleeding is still the leading cause of potentially preventable deaths in major trauma patients. Despite huge improvements in overall outcomes over the past 10 years, mortality from torso haemorrhage remains very high, and over 50% in some series. This is a national (UK & Ireland) meeting to bring together all MTCs, Air ambulances and anyone interested to discuss future management, pathways and prrotocols for bleeding management. (Worldwide attendees online are very welcome) The past year has seen two major clinical trials completed across the national trauma system – UK-REBOA and CRYOSTAT2. What does data from these trials tell us about our current pathways and practices for major haemorrhage. What should happen now? What are the implications of these studies? How should we change our practice? And can we look to the future to improve our decisions, practices and outcomes? The aim of the event is to use results from the trials and other contemporaneous data to facilitate a national discussion regarding how they should be incorporated into practice in the UK. We will cover the bleeding pathway from prehospital care through to operative or interventional haemorrhage control. The event will be fully interactive, and we would really like to bring out the views and experiences of front-line clinicians and transfusion practitioners. Day 1 - “What Now?” will focus on results and additional data from the trials, to discuss the place of REBOA and cryoprecipitate in future pathways, and also how we can improve our practices for non-compressible haemorrhage, critical bleeding, resuscitation and coagulopathy management in general. Day 2 - “What next?” focuses on challenges in decision-making, and introduces the COMBAT-AID programmes work to bring AI decision support to these patients. Draft programme is available on the registration pagee. The event is funded by the NIHR HTA and the US DoD COMBAT AID programmes. , and will be intentionally interactive – we would really like to hear everyone's views, thoughts and ideas. In-person attendance is limited to just over 150 attendees, and we have reserved spaces for representatives from UK & Ireland MTCs and air ambulance services. Some 40 or so additional places are available. If you would like to join us in person then please indicate whether you would like to be present in person for one or both days. We will inform you by Tuesday 27th February if we have secured space for you. The meeting will also be livestreamed so you can also register for online access. We look forward to seeing you, in person or online, and look forward to two days of intense discussion that will translate into new approaches and guidance for our patients. Please spread the word!

This week @London_Trauma System is publishing our Palliative and End of Life Care in Older Trauma Patients best practice guidance. Please share widely! c4ts.qmul.ac.uk/downloads/lm… Key Principles: All healthcare professionals involved in the care of older trauma patients have a responsibility towards the identification and management of an individual’s palliative and end of life care needs. Palliative support for older trauma patients should be provided in conjunction with, and not separate to, best available curative/life-prolonging interventions All older trauma patients should be looked up on local health records to see if they have an advance care pathway Prognostication at the outset can be difficult. Where the appropriateness of clinical interventions is uncertain, ‘time limited trial of treatments’ should be considered, alongside patients wishes and preferences. Effective communication between TUs and MTCs is essential and palliative care referral pathways should be in place within trauma networks to facilitate individualised decision-making. Where specialist services at MTCs are requested to guide treatment options, senior TU clinicians managing the patient should factor in and convey relevant information about a patient’s medical background and personal values, to enable shared decision-making on prognosis, treatment intentions and the best location of ongoing care. Thank you to @TraumaEMC and everyone involved in producing this guidance.