 The Toronto Prehospital Hypertonic Resuscitation-Head Injury and Multi Organ Dysfunction Trial TOPHR HIT is a randomized, placebo-controlled out of hospital trial of blunt trauma patients with head injuries. The study compares a group receiving normal saline according to a paramedics protocol, with a treatment group receiving a single dose 250 ml of 7.5 hypertonic saline in 6 dextran 70 RescueFlow BioPhausia AB, Stockholm Sweden. 