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The first edition of the Trauma Care Manual was published in 2000 in order to ‘begin the process of establishing United Kingdom guide­lines for best practice in the management of major trauma’. At the time we recognized both that this was an ambitious project and that further editions would be needed to ensure that the manual continued to reflect best prac­tice in a UK context. The second edition was issued in 2009, completely revised and with a number of new chapters. Perhaps, the most notable changes in the second edition were the adoption of the <C>ABCDE resuscitation sequence and of hypotensive resuscitation in uncontrolled haemorrhage. At this time, we were increasingly aware of the divergent paths of trauma resuscitation in the US and in the UK and wished also to reflect the developments which had resulted from clinical practice dur­ing the wars in Iraq and Afghanistan.

In 2019, Trauma Care issued the first edi­tion of the Trauma Care Pre-hospital Manual, believing that pre-hospital care was a sufficiently different specialty to require its own specifically tailored guidelines reflecting the particular chal­lenges of this area of practice. As a consequence, further editions of the Trauma Care Manual would concentrate entirely on hospital practice.

This third edition of the Trauma Care Manual has, once again, been completely revised and a further nine chapters introduced. New chapters include Infection in Trauma, Damage Control Surgery, Trauma Systems, Centres and Teams, CBRN and the Trauma Victim and Care of the Obese Trauma Patient. We have continued to offer didactic guidelines for clinical practice and each chapter is, wherever possible, extensively refer­enced. The features of earlier editions—tables, information boxes, clinical tips and illustra­tions—have been retained and expanded.

Again, since the second edition, we have changed our guidelines regarding fluid resus­citation: reflecting the currently available evidence in recommending, with certain spe­cific caveats, the use of hybrid resuscitation in uncontrolled haemorrhage, and we believe that the guidelines we offer are as up to date and evidence based as we can make them.

The production of a manual such as this requires a great deal of hard work and the edi­tors are grateful to all the contributors to this and to previous editions.

Trauma Care’s (and our) dear friend Prof. David Alexander died shortly after completing, with his colleague Prof. Susan Klein, the chap­ter on psychological responses to trauma. On re-reading this chapter during the final edit­ing, we can hear his voice of calm common sense and kindness expressed in prose which could only be his. Trauma Care has established the David Alexander Memorial Lecture in his memory to be given annually on a subject related to the mental health aspects of trauma.

The editorial team at Trauma Care has now embarked on the final one of our intended trio of manuals, the Trauma Care Paediatric Manual which will be published in the near future. We hope that the three manuals between them will make a significant contribution to the care of the trauma victim and to the confidence of those called upon to treat them.