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Tourniquets and inflation devices of suitable sizes should be available for upper and lower limb surgery requiring a bloodless field.

Cell salvage equipment should be available for cases where significant blood loss is anticipated.^74,75 Staff who operate this equipment should receive training in how to operate it, and should use it with sufficient frequency to maintain their skills.

A rapid infuser allowing the infusion of warmed intravenous fluids and blood products should be available in the anaesthetic room, operating theatre, recovery unit and ED.⁷⁶

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

A standardised ‘difficult airway trolley’ should be immediately available in all areas where major trauma patients are received or managed to level 2 (or greater) standards of care. These should be equipped as defined in the Difficult Airway Society (DAS) guidelines.^5,77,78

Patient positioning for elective and trauma orthopaedic surgery involves a variety of specialist equipment, tables and attachments. These should be suitable to care for patients across a wide weight range, with theatre personnel aware of the upper weight limits.^54,79

A patient-centred approach is preferred for documenting advanced care plans, which include overall treatment goals including resuscitation status. It should include discussing and planning treatments that should be considered, not just those that should be withheld.¹⁸

A fall of less than two metres is the most common mechanism of injury in older patients. Prehospital triage to aid early identification of severe injuries in older patients should be available to allow quick transfer from TU to a MTC for specialist investigation and intervention.⁹²

Older patients who are admitted following trauma should have a comprehensive geriatric assessment. The use of frailty screening tools may facilitate more informed early decision making in older trauma patients.⁹³

Protocols for end of life care should be in place to manage older patients with frailty who are unlikely to survive. The multidisciplinary team and patient’s family or next of kin should be involved in these decisions.⁹⁴