Acute trauma coagulopathy (ATC) is seen in 30% to 40% of severely injured casualties. Early use of blood products attenuates ATC, but the timing for optimal effect is unknown. Emergent clinical practice has started prehospital deployment of blood products (combined packed red blood cells and fresh frozen plasma [PRBCs:FFP], and alternatively PRBCs alone), but this is associated with significant logistical burden and some clinical risk. It is therefore imperative to establish whether prehospital use of blood products is likely to confer benefit. This study compared the potential impact of prehospital resuscitation with (PRBCs:FFP 1:1 ratio) versus PRBCs alone versus 0.9% saline (standard of care) in a model of severe injury. 

Conclusion: "Anesthesiologists should become more involved in the development of resuscitation guidelines. Resuscitation is a multidisciplinary effort and can only benefit from the participation of anesthesiologists. We anesthesiologists have proved that we can change patient outcomes for the better. What better place to expand this contribution than in the area of medicine in which patients have the grimmest outcomes of all?"