There has been huge interest from Indian doctors in the international CRASH-2 trial and already over 100 Indian hospitals are taking part with over 1,000 patients randomised in India alone. Hundreds more Indian hospitals are in the process of obtaining ethics committee approval to join the trial. This newsletter highlights the important contributions that Indian doctors are making to this global collaborative effort.

In India someone dies from trauma every two minutes. Most of the victims are young men killed in road traffic crashes, and in many cases the resulting loss of family income will have very serious repercussions on their families. The available evidence suggests that the trauma problem in India is getting worse rather than better. Effective prevention is of course the key, but there can be no doubt that India is faced with a major epidemic of trauma with hundreds of thousands of trauma patients requiring effective treatment.

The CRASH-2 trial is an international collaborative randomised controlled trial of the effects of tranexamic acid in bleeding trauma patients. The trial is funded by the UK National Health Service and is supported by the World Health Organization. If such a simple and widely practicable treatment as tranexamic acid could reduce mortality after trauma by just a few percent, then this inexpensive treatment could prevent many thousands of trauma deaths each year, both in India and worldwide.

Through their active participation in the CRASH-2 trial, trauma doctors in India are making a major and permanent contribution to the evidence base for trauma care, which will improve the care of trauma patients worldwide.

All India Institute of Medical Science team in New Delhi

Christian Medical College Hospital in Ludhiana

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