"Unexpected survivors" are those patients who, according to their injury severity score, should die of their injuries but they survive against the odds.. The years of conflict in Afghanistan saw increasing numbers of these grievously injured patients surviving to live a fulfilling life. How was this achieved? This talk will cover rewriting the ABCDE of ATLS, the delivery of self and buddy first aid, the use of novel haemostatics and tourniquets, rapid delivery of specialist pre-hospital emergency care by physician-led teams, AKA the Medical Emergency Response Team or MERT, with high quality pre-hospital interventions such as io access, blood transfusion, RSI, analgesia and how these lessons learned from the battlefield can be translated in to civilian practice. However, sometimes the very best we can do isn’t enough, because of the catastrophic nature of the patient’s injuries and a vital lesson learned is to how to cope when your best just isn't good enough.
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