(i) Initial resuscitation of the trauma victim

The initial management of the trauma victim has evolved over many years. Changes have occurred in both pre-hospital and hospital practice and in the overall approach to patient management. The focus of patient care is now aimed at maintaining the patient's physiological state whilst obtaining an early CT scan of the head, spine and trunk to identify all injuries. However, in the critically ill patient with active bleeding the immediate surgical control of haemorrhage is essential. Recent developments in trauma management, including damage control resuscitation, more rapid imaging, improved methods of haemorrhage control and the identification of patients who would benefit from either early total care or damage control orthopaedics have all led to improved outcomes in the trauma patient.