Key Messages
The Victorian State Trauma System (VSTS) provides support and retrieval services for critically ill trauma patients requiring definitive care, transfer, and management.
This inter-hospital transfer guideline provides evidence-based advice on the transfer of major trauma patients who present to Victorian health services with severe injuries.
Inter-hospital transfer to a major trauma service (MTS) should be initiated soon after arriving at the primary hospital to reduce delaying definitive care. Major trauma patients who receive definitive care in an MTS have reduced morbidity and mortality. The VSTS aims to ensure that major trauma patients receive their definitive care at a MTS.
Adult Retrieval Victoria (ARV) or Paediatric Infant Perinatal Emergency Retrieval (PIPER) should be contacted within 60 minutes of arrival at hospital of a patient meeting the major trauma transfer criteria. Once notification of the trauma patient has been received, the retrieval service will provide specific expert advice regarding clinical management as well as coordination of transfer to a MTS if required.
The requirement of an inter-hospital transfer of a major trauma patient can be recognised by certain vital sign markers; the presence of a specific physiological or anatomical injury; deterioration associated with a high-risk mechanism of injury; or being a high-risk patient (1).
This guideline is developed for all clinical staff involved in the care of trauma patients throughout Victoria. It is intended for use by frontline clinical staff that provide care for major trauma patients; those working directly at the MTS as well as those working outside of a MTS.
This guideline provides the user with accessible resources to provide appropriate care effectively and confidently for critically injured patients. This provides up-to-date information for frontline healthcare clinicians. The guideline has followed the AGREE II methodology for guideline development and is under the auspice of the Trauma System Advisory Committee (TSAC) (2).
Clinical emphasis points
- Early identification of major trauma criteria requiring inter-hospital transfer should be achieved using the defined triage guidelines.
- Early activation of the retrieval and transfer system should take place.
- All inter-hospital transfer of adult major trauma patients should be referred via Adult Retrieval Victoria (ARV: 1300 36 86 61).
- All inter-hospital transfer of paediatric major trauma patients should be referred via Paediatric Infant Perinatal Emergency Retrieval (PIPER: 1300 137650).