6 Implications for the NHS
6.1 Estimates of the numbers of trauma patients given pre-hospital IV fluid range from 8.6 to 65 patients per 100,000 population per year. The population of England and Wales is about 57 million, so pre-hospital IV fluid is likely to be administered to between 5000 and 37000 trauma patients annually.
6.2 The cost of IV fluid replacement therapy in the pre-hospital phase is primarily determined by the unit cost of the IV fluid and the cost of the ambulance crew. A small cost increase for ALS was observed in the economic studies, predominantly because more time was spent at the scene. There is also likely to be substantial regional variation in costs, according to unit costs of services across ambulance trusts.
6.3 Given the absence of reliable information on the current use and cost of pre-hospital IV fluids in people with trauma, it is difficult to quantify the likely cost of implementing the recommendations in Section 1. Limiting the use of pre-hospital IV fluid in the treatment of trauma patients would be unlikely to yield monetary savings within the ambulance service, but it could save time at the accident scene. This might release resources within the ambulance service – contributing to improved response times – and lead to small improvements in overall efficiency.