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St Emlyn's Blog and Podcast
Duration 29:02
Date: Feb 24 2026
• Recognise the small cohort of trauma patients with likely non-compressible haemorrhage who cannot be definitively treated in the pre-hospital setting.
• Describe the principles of damage control pre-hospital care, including time as a treatment and prioritisation of haemorrhage control over other interventions.
• Outline how to structure scene, ambulance and emergency department phases to minimise time to surgical haemorrhage control.
• Discuss how to communicate damage control pre-hospital decisions with ambulance crews, trauma teams and dispatch.
• Reflect on governance, debrief and training processes that support safe adoption of a damage control pre-hospital standard operating procedure.
• Recognise the small cohort of trauma patients with likely non-compressible haemorrhage who cannot be definitively treated in the pre-hospital setting.
• Describe the principles of damage control pre-hospital care, including time as a treatment and prioritisation of haemorrhage control over other interventions.
• Outline how to structure scene, ambulance and emergency department phases to minimise time to surgical haemorrhage control.
• Discuss how to communicate damage control pre-hospital decisions with ambulance crews, trauma teams and dispatch.
• Reflect on governance, debrief and training processes that support safe adoption of a damage control pre-hospital standard operating procedure.MedPod Learn is an educational app that helps clinicians learn on the go using podcast content. It supports clinical reasoning, exam preparation, and reflective practice.
• In penetrating torso trauma with profound shock, a single well-sited large-bore line is often enough to start blood products; chasing a second line may waste precious minutes.
• Early wound packing and control of compressible haemorrhage can buy the time needed for transfer, even when non-compressible bleeding is the main threat.
• A short, focused pre-alert such as “adult, code red, damage control, penetrating chest” can give the trauma team more usable preparation time than a late, detailed report.
• Hot debriefs at the hospital entrance help explain deliberate omissions of interventions to colleagues and support psychological processing for pre-hospital teams.
• Spending long periods on scene performing advanced airway procedures, bilateral thoracostomies and packaging in patients who mainly need rapid access to a surgeon.
• Treating every major haemorrhage case as suitable for damage control transport without checking for other priorities, such as isolated head injury or unclear mechanisms.
• Attempting complex procedures in the back of a moving ambulance without planning safe stops, seatbelts and roles with the ambulance crew.
• Assuming that a patient who looks better after pre-hospital blood products is now stable, rather than still actively bleeding and needing immediate operative control.
• Review recent major haemorrhage cases to identify any patients who might have benefited from earlier recognition of non-compressible bleeding and faster transfer to theatre.
• Rehearse with local ambulance colleagues how you would label and manage a “damage control” case, including who places the early pre-alert and what language they use.
• Work with emergency department and surgical teams to define a pit-stop pathway for exsanguinating patients that bypasses routine imaging and moves rapidly toward the right theatre.
• Integrate hot and cold debriefs for these rare cases into your governance structure, so that omissions of care and system learning are discussed explicitly.