The term 'prehospital' must be justified when reporting animal studies of traumatic hemorrhagic shock.

Clinical trials in prehospital medicine can be particularly challenging especially in the area of acute resuscitation. Numerous preclinical (animal) studies investigate different resuscitation techniques following traumatic hemorrhagic shock. Some of these studies have adopted the term 'prehospital' to indicate a period in the experimental protocol corresponding to the prehospital evacuation of a casualty in the clinical setting. With a plausible biologic narrative and appealing explanation, such studies have the potential to be misleading and lack credibility due to lack of translatability. The true prehospital emergency evacuation of a patient from point of injury to hospital is characterized by urgency, noise, unpredictability, multiple patient transfers, patient movement, variation in temperature and humidity, and interference in delivery of clinical interventions and technical skills. Logistical and practical constraints are also implied by the use of the term 'prehospital', since multiple specialists, modes of transport, coordination and resources are necessary. If a research question in a preclinical experiment is designed to test a 'prehospital' phase then both the animal model and protocol ought to be credibly justified in the methodology of the study to address such factors. (C) 2016 Lippincott Williams & Wilkins, Inc.

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