You’re about to hear a conversation about doing less. But it isn’t really about doing less. It’s about time.

Recorded at Trauma 2030 at the Royal College of Surgeons, this episode explores a shift in mindset in pre-hospital trauma care — away from maximal intervention on scene and towards rapid recognition of the patient who cannot be fixed pre-hospital.

I’m joined by Harriet Tucker — consultant at London’s Air Ambulance, HEMS Governance Lead at Air Ambulance Kent Surrey Sussex, and Trauma Team Leader at St George’s Major Trauma Centre — to talk about damage control pre-hospital care.

We discuss:

• Using time as a treatment

• Recognising non-compressible haemorrhage

• Why one line may be enough

• Moving interventions into the ambulance

• Changing the pre-alert

• The “pit stop” resus

• Taking patients straight to theatre

• Cultural resistance to doing less

• Governance, debrief, and looking after teams

This approach focuses on a small but critically unwell group of patients — often penetrating trauma with rapidly exsanguinating haemorrhage — where the only definitive treatment is surgical control of bleeding.

The key intervention is speed.

Harriet also discusses the governance work behind this change, the importance of reviewing every case, and how to bring ambulance services and in-hospital teams along with the shift in thinking.

This episode is part of a series recorded at Trauma 2030. More conversations from the meeting will follow in upcoming episodes.

Upcoming events

Harriet will be speaking at Tactical Trauma, 2–4 November, Sundsvall, Sweden.

IncrEMentuM is now only eight weeks away, with limited tickets remaining.

Learning from podcasts?

If podcasts form part of your CPD, you can log your listening time across all podcasts on MedPod Learn — not just St Emlyn’s — and generate structured reflection. The app is free to download, includes a one-month free trial, and offers globally adjusted pricing.