Theory 12/Emergency Medicine & Triage
Survival Is Time Against Reserve
The claim
Trauma survival is set by the ratio of time to definitive care to physiological reserve, so the same delay is survivable for a fit patient and fatal for a depleted one.
01The mechanism
Haemorrhage consumes reserve while the patient waits. Survival depends on whether the clock outruns the reserve, which is a ratio rather than a time.
That makes reserve a modifier of the time target, which explains why fixed transport targets perform differently across populations.
02What this is not
Fixed time-target models
Those set a universal clock. This scales the clock to reserve, which explains outcome variation at equal delay.
03Predictions
- P1Survival should track the ratio.
- P2Reserve markers should predict who benefits from faster transport.
04Refutation
Survival tracking delay regardless of reserve would favour fixed targets.