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Prehospital care for major trauma victims is a balance of timely delivery to definitive care and appropriate intervention to maximize probability of survival. In the development of advanced, organized prehospital care systems, the evidence for the benefit of individual interventions has been limited and contradictory. Leading controversies reviewed are: the place of advanced life support, the role of doctors compared with paramedics, the optimal advanced airway adjunct, the role of intravenous fluids in serious injury, and the value of prehospital cardiopulmonary resuscitation following traumatic cardiac arrest. International differences in trauma epidemiology are discussed. The identification of prehospital care as the weak link within a trauma system is highlighted.

Damage Control Resuscitation (DCR) is a novel concept that draws together a series of technical and organisational advances in combat casualty care. It is consistent with and encapsulates the established concept of damage control surgery (DCS).

Oestrus ovis is the most common cause of human ophthalmomyiasis, and infection is often misdiagnosed as acute conjunctivitis. Although it typically occurs in shepherds and farmers, O. ovis ophthalmomyiasis has also been reported in urban areas. We report the first case study of O. ovis infection from Afghanistan.

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The public perception of excessive timelines for pre-hospital care in Afghanistan has been distorted. The ground truth is a pre-hospital time less than one quarter of the cited 7 hours for the seriously injured subset of UK Service personnel.

This paper is a record of the UK Defence Medical Services (DMS) contribution to the UK response to the Ebola crisis in West Africa from the start of planning in July 2014 to the closure of the Ministry of Defence Ebola Virus Disease Treatment Unit at the end of June 2015. The context and wider UK government decisions are summarised. This paper describes the decisions and processes that resulted in the deployment of a DMS delivered Ebola Treatment Unit in conjunction with the Department for International Development and Save the Children. It covers arrangements for medical care for disease and non-battle injury, the Air Transportable Isolator and Force Health Protection policy, and finally, considers the medical lessons from this deployment. The core message is that the UK DMS are the only part of the UK health sector that is trained, equipped, manned and available to rapidly deploy and operate a complete medical unit as part of an international response to a health crisis.

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