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 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 en route, are essential aspects of early care. Delaying transfer to obtain laboratory results or imaging studies may simply delay access to definitive treatment. Often such studies must be repeated at the receiving facility.
All health services should avoid a patient deteriorating during an inter-hospital transfer by transferring these patients to a major trauma centre quickly. 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.
In liaison with ARV clinicians, contact Paediatric Infant Perinatal Emergency Retrieval (PIPER) if required and the receiving hospital. Confirm with both about the interventions to be used to stabilise the patient before retrieval personnel arrive. ARV will coordinate communications and retrieval and will evaluate the practicality and clinical needs involved in transferring the patient from the source 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 make changes to care to ensure the patient is safe during transfer.
Adult Retrieval Victoria recommends the IRMIST-AMBO method of handover for facilitating health professional communication and ensuring clarity and completeness.