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Equipment to facilitate haemodynamic and cardiac output monitoring should be available.

A ‘difficult airway trolley’ should be immediately available in all areas where major trauma patients are received. These should be equipped as defined in the Difficult Airway Society (DAS) guidelines, and include video laryngoscopes, fibreoptic scopes, jet ventilation and surgical airway equipment.^11,23,24

In MTCs and TUs, the resuscitation room receiving bays should be large enough to allow simultaneous emergency procedures to be performed by trauma team members.³⁴

Hospitals that receive patients with major trauma should ideally have an emergency operating theatre and a radiology intervention suite situated sufficiently close to the ED to allow rapid transfer of trauma patients.

An emergency operating theatre should be rapidly available at all times for major trauma patients. The available equipment should be suitable for a full range of emergency trauma procedures. Use of this theatre for non-urgent cases should be tightly controlled. If the designated emergency theatre is occupied, there should be a robust, flexible and agreed backup plan to obtain an...

MTCs receiving major trauma patients should have a trauma theatre equipped with a radiolucent operating table that allows fluoroscopic imaging of all body parts without repositioning the patient.

Primary and revision arthroplasty surgery, along with trauma surgery involving bone implants or internal fixation should be carried out in an operating theatre with multiple air changes per hour (e.g. laminar flow).

Appropriate facilities for rest breaks should be provided according to defined norms.^{6,10,11,12,13}

Point of care testing for haemoglobin, blood gases, lactate, ketones, coagulation, viscoelastic measurements and blood sugar should be available during surgery for patients with major trauma and those undergoing orthopaedic procedures associated with a risk of haemorrhage.²⁴ If near-patient testing is not available, laboratory testing should be readily and promptly available.

Use of point of care ultrasound (POCUS) is recommended as a useful adjunct to the primary survey in acute trauma.^{26, 27}