Prehospital partial REBOA for exsanguonating torso haemorrhage. The P-PRO study published today in @JAMASurgery. This is the environment, and these are the patients REBOA was developed for. jamanetwork.com/journals/jam… Congrats @robbielendrum @LDNairamb and all involved.

Grateful to @BBCLondonNews for focusing this week on knife violence in children and young people. Across the @London_Trauma System we easily see 3000+ stabbings every year, the majority in young people. We do a huge amount to try to rescue these people from the situation they're in, bringing youth workers, police teams, psychologists and multiagency teams in to support them after discharge. But it's hard to turn people's lives around when the social fabric around them is so broken and has been all their lives. There is too much stress (and distress) of all kinds - financial, social, mental - on them, their families and community. We have lost many/most of the structures and safety nets that previously used to support and protect people. Here's my policy wish-list (evidence-based) for what would make a real, lasting difference for this generation and the next: 1. More money in parents' pockets (so less stressed have have more time with their kids) 2. High quality widely available early and primary years child care 3. Enhanced primary school education. Free school meals including breakfasts. Dedicated time with parents (reading etc) 4. Large scale re-establishment of youth centres with dedicated in-reach from multiple services. 5. Massive expansion in youth workers who themselves need better support (and pay) 6. At-risk screening across all school age children including learning disability and mental health screening. 7. Funding for additional support to stop school exclusions (and removing the policies that encourage them) 8. More support and tools for communities to take responsibility. Funding for local place-based actions 9. Widespread uptake and training of trauma-informed approaches across all involved agencies 10. Bring young people's voice into all these conversations and actions. Lots of people and groups are doing amazing work with young people. Ultimately society needs to be rebuilt. And that means money needs to be directed to those who have less. The picture is of the London Trauma System's public health approach to violence reduction. More info: (PDF) tinyurl.com/yc2ushva

That massive post-trauma troponin rise you've been ignoring? That's dead myocardium.

UK-REBOA results: REBOA increased mortality at 90 days and at all interim time points. REBOA increased deaths due to bleeding at 3 hours and 90 days. REBOA substantially delayed time to definitive haemorrhage control. 💢🎈💢 #ccr23