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Background: Major trauma patients are invariably received in the emergency department by a combination of emergency department and trauma team staff. The initial assessment is largely protocol led, using Advanced Trauma Life Support (ATLS) guidelines. The task of ordering and prescribing blood products often falls to the more junior members of this team. Aim: The aim of this postal questionnaire survey was to quantify the use of transfusion guidelines for major trauma in the UK and to assess whether generic national guidelines might be beneficial. Methods: A questionnaire was sent to all major emergency departments in the UK with an attendance .50 000 patients per year (total = 167). A reminder was sent to all non-responders. Each trust was asked whether guidelines are used; which blood products are specified; how useful they consider them to be; and how well they are adhered to. Results: 109 questionnaires (65%) were returned, of which only 17 (16%) currently use major trauma transfusion guidelines. While few trusts currently use guidelines, those being used were found to be very similar. Each trust was asked how useful their guidelines are, using a linear score of 0 to 5 (mean score 3.7). Those without guidelines were asked how useful they thought major trauma guidelines would be (mean score 3.3). Conclusion:The appropriate ordering and use of blood products has major clinical and cost implications. Few trusts currently have guidelines for major trauma despite being enthusiastic regarding their use. The authors propose there is now a role for national major trauma transfusion guidelines within the UK.Major trauma patients comprise a vulnerable group, often requiring rapid treatment plans despite invariably having complex medical demands. Their optimal transfusion requirements have been the topic of much recent research and debate, particularly relating to the use of individual blood products. To date, this work has not been combined to produce generic national guidelines.The aim of this postal questionnaire study was to quantify the proportion of major emergency departments in the UK using trauma transfusion guidelines and consider whether the introduction of generic national major trauma transfusion guidelines could be beneficial.

The pandemic, rising inequalities, climate change, consumer mistrust of brands, organizations and their intentions, pose important questions relating to marketing’s relevance and impact in the real world. Additionally, there are growing calls by global bodies, such as the UN, national governments, consumers, students, suppliers, and leading practitioners to re-imagine and broaden the role of business and marketing to consider benefits to stakeholders (consumers, suppliers, employees, community, as well as shareholders). In this editorial, we contend that the United Nations Sustainable Development Goals (UN SDGs) framework has the potential to address the myriad of challenges identified by marketing scholars and practitioners. With the assistance of quotes from marketing scholars, non-marketing scholars, marketing students and practitioners, we offer a rationale for a proactive and considered engagement by marketing scholarship, with the UN SDGs. We then introduce the six papers included in this special issue. We conclude by calling for further critical inquiry at the marketing-SDGs interface including; 1) Re-imagining the philosophy of marketing and marketing education; 2) Marketing capabilities and the SDGs; 3) Understanding consumer behavior, and 4) Learning across contexts.

A case is presented in which a high velocity rifle (shotgun) was fired into the inferior part of a patient's face in an attempted suicide causing widespread trauma to the inferior and left side of the patient's face. He presented to his general practitioner where an ambulance was called. The patient is followed from prehospital care (air ambulance) to resuscitation in accident and emergency and through the first stages of reconstructive surgery. The article focuses on the multidisciplinary approach to the patient's prehospital care and initial resuscitation at a major trauma centre. CT reconstruction images of the patient's skull allow visualisation of the extent of bone damage at presentation. Medical photography allows visualisation of the extent of the initial damage and shows how reconstructive surgery was undertaken early and in progressive stages. A literature review was performed allowing discussion of the current evidence and best practice in the management of facial gunshot wounds.