Trauma care has long been characterised by empiric, protocol-driven interventions. While these approaches provide a broad framework, there is a growing recognition that treatment should be tailored to each patient’s unique physiology and injury profile. In contrast, fields such as oncology have embraced diagnostic precision and targeted therapies with demonstrable benefits. Recent trials in trauma, including the CRYOSTAT2 and PROCOAG studies of empiric cryoprecipitate and prothrombin complex concentrate, show that a ‘one-size-fits-all’ approach is not sufficient.1 2 To improve outcomes, we must transition to precision trauma care, with accurate, robust diagnostics and guided treatments targeted at the individual patient in front of us.

Fibrinogen is a critical component of haemostasis, and its depletion in trauma is associated with poor outcomes, including increased mortality and the need for massive transfusion. The CRYOSTAT2 trial demonstrated that while fibrinogen replacement is necessary for some patients, indiscriminate administration to all trauma patients does not confer a survival benefit and may introduce harm. Effective administration of replacement fibrinogen will be dependent upon the ability to accurately identify patients with …