Introduction: This study reports the epidemiology and outcomes from out-of-hospital

Fluid resuscitation appears to reduce the risk of death in animal models of severe hemorrhage but increases the risk of death in those with less severe hemorrhage. Excessive fluid resuscitation could therefore be harmful in some situations. Hypotensive resuscitation reduced the risk of death in all the trials investigating it. An evaluation of the potential impact of hypotensive resuscitation in humans could now be warranted.

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On this evidence, it is not possible to predict the effect most interventions will have on recruitment. Funders and researchers should ensure that the evaluation of recruitment strategies are incorporated into research studies.