Transfer and retrieval response will be managed according to patient need following clinical consultation.

It is important to note that an exhaustive clinical workup and interventions are not always necessary or appropriate prior to transfer. Stabilisation and ensuring life-threatening problems are addressed, as well as taking measures to prevent deterioration enroute, are essential aspects of early care. Delaying transfer to obtain laboratory results or imaging studies may simply delay access to definitive treatment.

Currently in Victoria, obstetric trauma specialists and facilities are located in metropolitan Melbourne, with patients transferred to the combined Royal Melbourne and Royal Women’s site as a first-line destination. Obstetric patients who do not meet time-critical major trauma guidelines for transfer may be referred to the nearest hospital with trauma and obstetric capacity.

First contact should be to ARV as well as contact with Paediatric Infant Perinatal Emergency Retrieval (PIPER), then the appropriate retrieval and transfer process can begin. In liaison with ARV and PIPER clinicians, interventions to stabilise the patient prior to retrieval personnel arriving should commence. ARV will coordinate the retrieval and will evaluate the practicality and clinical needs involved in transferring the patient from the referring hospital. Once retrieval staff arrive on scene, be prepared to give a thorough handover. Retrieval staff will assess the patient prior to transfer and may update care in order to ensure the patient is safe during transfer.

Adult Retrieval Victoria recommends a standardised recognised handover tool such as ISBAR or IMIST-AMBO to facilitate clarity and completeness amongst health professionals and patient safety.^{(6, 7)}