Where an MTS is within 45 minutes’ transport time from the incident scene, the patient with pMT should be taken to that service, bypassing other hospitals in order to minimise the time from injury to definitive care. This will also avoid the need for subsequent inter-hospital transfer later on. (This also applies to an older patient with an isolated head-injury for whom a 45-minute transfer to an MNS/MTS is appropriate.)
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.