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Appropriate early referral to the acute pain services and use of regional analgesia should be considered in patients with chest trauma.¹⁰¹

The diagnostic and therapeutic applications of POCUS in trauma are expanding. There should be emphasis on quality training and a robust governance process for operators within the trauma multidisciplinary team.¹⁰²

Major incident training exercises should take place at regular intervals.

Organisations should provide mandatory training relating to advance care planning and resuscitation policies and documents.^35,103

Educational opportunities for anaesthetists in training in MTC and TU will undoubtedly occur during predictable job planned consultant direct clinical care sessions out of hours as a result of the nature of trauma. Hospitals in which anaesthetists in training work a full or partial shift system should consider providing additional consultant programmed activities to allow training and supervision to take...

Hospitals should consider training ED staff in acute pain management of both adult and paediatric patients with trauma, in particular using ultrasound-guided femoral nerve block or fascia iliaca block for hip fractures in elderly patients and femoral fractures in children.^41,104

The definitive care of complex spinal and pelvic injuries requires early multidisciplinary specialist spinal (orthopaedic or neurosurgical surgery) and pelvic team discussion. The anaesthetist managing such cases should have appropriate training and experience in management of these complex patients including management of associated complications.

All sites should consider participating in active research studies on the National Institute for Health and Care Clinical Research Network portfolio for Trauma and Emergency Care.¹⁰⁵

All MTCs should have a dedicated research lead with appropriate job planned time and should receive training on ethical and organisational issues.¹⁰⁶

All clinicians involved in trauma care should be aware of active studies and consider completing good clinical practice training and participating in screening and recruiting of research participants.^105,107