I recently was invited to co-author an important paper on knife violence, for the publication – Scientific Reports. The paper details a single centre experience in the change of patterns of knife injury between 2012-2018.

It confirms a number of disturbing findings:

• A steady increase in the number of knife injuries in total
• A decrease in the average age of victims, and;
• In younger patients a movement towards multiple rather than single stab wounds affecting junctional areas and the limbs.

This change in injury pattern is significant; it speaks towards an increase in collective rather than individual assaults, and more worryingly that exsanguination is more likely to be the mode of death. People are literally bleeding to death on our streets.

This sobering disclosure justifies the development of the VRU which has done so much to understand and mitigate the nature of interpersonal injury.

I recommend you read this paper. On a very practical level, it is a clear signal that the dissemination of bleed control skills, that identify and address life threatening haemorrhage is a vital step forward in mitigating these potentially fatal events. Appropriately trained “zero responders” have a place in alerting ambulance services and delivering life and limb saving interventions prior to their arrival.

We should remember, though, London remains a safe and vibrant global city with an amazing trauma system and a nation leading VRU that is transforming our understanding and reduction of all forms of violence, however the data within this paper tells is clearly that there is still much more for us to do.

Martin P Griffiths CBE DL FRCS FRSA

Find out more about the Scientific Reports publication here.