Adult Retrieval Victoria (ARV: 1300 368661 - Adult Patients) or Paediatric Infant Perinatal Emergency Retrieval (PIPER: 1300 137650 - child < 16 years of age) is the first point of call for: MTS hospitals that are contacted directly by a referring hospital will refer cases to ARV or PIPER to coordinate clinical advice and transfer.
ARV and PIPER coordinators can facilitate a three-way conversation between the referral health service, the accepting trauma facility and a retrieval consultant to discuss the best, timely management of the patient.
The decision of when to transfer an unstable patient should ideally be made by the transferring and receiving clinicians in collaboration with the retrieval service9.
It is important to emphasise the necessity for consultation in order to clarify the need for transfer for patients who meet the major trauma transfer criteria. This may also allow for alternate management pathways in the following circumstances:
Notification of the arrival of a patient who meets the major trauma inter-hospital transfer criteria.
Activation of a request for retrieval.
The patient’s injuries are assessed as not severe enough to warrant transfer.
The referring hospital has the capacity to provide appropriate definitive treatment.
The MTS is in agreement not to transfer in a particular case.
Transfer from a peripheral hospital to a regional trauma service is appropriate for the needs of the patient.
If telemedicine facilities exist they have a significant benefit in managing trauma, enabling prompt diagnosis and interventions in patients referred from metropolitan and rural facilities11. Using this system with the retrieval service can assist by augmenting the delivery of timely, appropriate care, including appropriate patient transfer.
Pre-transport communication and coordination
The following should occur before a patient is transported:
a telephone or videoconference referral, gathering of history, examination, vital signs and initial investigations
discussion between referring and receiving senior medical staff, and agreement that transfer is feasible, beneficial and should proceed
stabilisation advice and institution of any additional management by the referrer
agreement regarding the required medical and/or nursing attendants during transport
a decision as to the appropriate mode and timing of transportation that considers
the patient’s condition, age and size
the urgency of transfer
medical interventions anticipated
personnel and other resource availability
the time of day
the weather and/or traffic conditions
a decision regarding the required monitoring, equipment and medication.