Between us, we see both ends of the same problem. One of us tracks resistant organisms through the surveillance data; the other reconstructs the tissue they have destroyed. The picture from both ends is the same: up to 37 per cent of casualties who reach definitive care in Ukraine are carrying infections resistant to every antibiotic available. Some are resistant to drugs that did not exist as a resistance target three years ago. In 2024, we identified carbapenem-resistant gr

Consider what happens in the first hour of a major trauma case. A patient is treated at the scene by para-medics – immediate care is given and vital signs are recorded. This continues in the ambulance or helicopter. A paramedic calls ahead to the hospital. A trauma team assembles to accept the patient, maybe reads a paper handover form, and begins their own assessment from scratch. In that “golden hour”, an extraordinary amount of data could be generated - temperature trajec

I come from investment, not medicine. Twenty years in healthcare finance teaches you to look for the gap between what a problem costs and what it would cost to solve it. When Jeremy Mauger described what he was watching happen to patients on cold, hard scoop stretchers with multiple transfers between trolleys — core temperatures dropping during transfer, clotting systems already failing by the time they reached the resuscitation room — the gap was obvious. The clinical evide

In trauma, both physical injury and physiological deterioration can impact mortality. A patient is extracted from a road traffic collision. The injury is potentially survivable. We stop the haemorrhage, secure the airway, ensure respiration and circulation are stable and then consider hypothermia. This is all in line with the MARCH protocols for trauma. By the time that patient reaches the resuscitation room, their core temperature is dangerously below 35 ℃, that is below the