Assessment and initial management of major trauma: summary of NICE guidance

Trauma is a major contributor to the global burden of disease. Those who experience major trauma have serious and often multiple injuries associated with a strong possibility of death or disability. Nationally there are around 20 000 cases of major trauma per year in England, and over a quarter of these result in deaths.1 Trauma care is a developing field, and recent civilian and military research has led to changes in the assessment and management of severely injured patients. This article summarises the most recent recommendations from the National Institute for Health and Care Excellence (NICE) on the assessment and initial management of major trauma. These guidelines sit as part of a suite of trauma guidelines2 3 4 5 6 and alongside the previously published guidelines on head injury.7 They are written in the context of the NHS, where trauma care was reorganised into major trauma networks in 2012. Here we focus on two central themes of the guidelines—the assessment of a patient with major trauma and the management of patients who are actively bleeding.