Extensive animal and human research has progressively modified post‐trauma fluid resuscitation over the past decades and, despite major advances, several related topics continue to generate intense research interest. In particular, the limitations of both conventional crystalloid and colloid solutions have prompted resurgent interest in the use of hyperosmotic fluids for resuscitation of the multiply injured patient in the presence or absence of concomitant head injuries. This review focuses specifically on recent articles that address clinically important problems related to prehospital and emergency centre resuscitation following severe hypovolaemic shock of the multiply injured patient.