This guideline covers the rapid identification and early management of major trauma in pre‑hospital and hospital settings, including ambulance services, emergency departments, major trauma centres and trauma units. It aims to reduce deaths and disabilities in people with serious injuries by improving the quality of their immediate care. It does not cover care for people with burns.
NHS England’s clinical reference group (CRG) produce the service specification for major trauma. The CRG intends to consider the NICE guidelines on major trauma, major trauma: service delivery, spinal injury and complex fractures in future updates to the service specification which are planned for 2017.
This guideline includes recommendations on:
- immediate destination after injury
- airway management
- management of chest trauma in pre-hospital and hospital settings
- management of haemorrhage
- pain management
- information and support for patients with major trauma and their families and carers
Who is it for?
Healthcare professionals and practitioners who provide care for people with major trauma in pre-hospital and hospital settings.
People with major trauma, their families and carers.
Guideline development process
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.