Where a MTS is within 60 minute transport time from the incident scene, the patient with pMT should be taken to that service, bypassing all other hospitals in order to minimise the time from injury to definitive care. This will also avoid the need for subsequent inter-hospital transfer. This also applies to patients over the age of 65, who have suffered a fall (<1m) causing a head injury with an isolated reduction in their GCS. This patient cohort should be transported directly to a MNS/MTS within 60 minutes, and all other hospitals should be bypassed.
If the flight time is more than 45 minutes and the adult patient has signs of persisting hypovolaemic shock despite resuscitation, a blood transfusion can be commenced pre-hospital. Consultation with the ARV coordinator for destination planning will occur (this may include diversion to a regional trauma service (RTS)). If the patient does not have signs of persisting hypovolaemic shock, they will be transported directly to an MTS.