Haemostatic resuscitation - aims to avoid lethal triad of hypothermia, acidosis and coagulopathy, the first 2 of whichall of which interfere with both coagulation(platelets one pseudopodia at 7.4, clotting factors work less well) and haemodynamic performance (acidosis impairs contractility, makes arrhythmia more likely, causes vasodilation and increases PAP). Aims: Rapidly correct these abnormalities (fluid warmers/bairhugger/Ca2+) and use a 1:1:1 ratio of PRBC to FFP to platelets - aim to do this in the first 6 hours (PROMMT). Limit crystalloid load (acidosis and dilution coagulopathy), do not use HES (clogs kidneys) or Gelo. (incorporates into clots). Consider tranexamic acid. 1:1:1 ratio still debated but some evidence for it (PROMMT).