Retrieval and transfer

Inter-hospital retrieval and transfer of major trauma patients is a crucial phase in patient care. The process of retrieving trauma patients from a referring health facility has the primary objective of improving their outcomes through coordinated support and timely transfer to an appropriate trauma service by highly capable transfer teams ⁽¹⁸⁾.

It is important to note that an exhaustive clinical workup is 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.

Staff should be prepared to provide a thorough handover to the retrieval team upon their arrival. Retrieval staff will assess the patient prior to transfer and may make changes to their care to maximise patient safety 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 ⁽¹⁰⁾.

Ensuring patient readiness for transfer

Final preparation of the patient should be made before the actual move, with conscious anticipation of their clinical needs. The patient must be reassessed before transport begins, especially after being placed on retrieval monitoring equipment and a transport ventilator (if used). Transport preparations must not overshadow or neglect the patient's fundamental care. An example of a check on the patient is listed below:

• The airway is secured and patent.
• Ventilation is adequate; respiratory variables are appropriate.
• All equipment alarms are switched on.
• The patient is haemodynamically stable.
• Vital signs are displayed on transport monitors and are clearly visible to transport staff.
• PEEP/CPAP (if set) and FiO2 levels are correct.
• All drains (urinary, wound, or underwater seal) are functioning and secured.
• The underwater seal drain is not clamped.
• Venous access is adequate and patent.
• Intravenous drips and infusion pumps are functioning properly.
• All electrical equipment is plugged in and charged.
• The patient is safely secured on a trolley.

Notify the patient’s family or next of kin of their transfer and ensure all the patient’s property is secured.

ARV or PIPER will provide updates to the receiving trauma services enroute to ensure staff are fully aware of the patient’s condition and are ready to intervene, when necessary, on arrival to the MTS.