In all cases, the decision regarding the timing of the transfer and the retrieval destination will be coordinated by ARV clinicians in consultation with the receiving facility.
Patients with an isolated SCI and neurological deficit should be transferred to the Victorian Spinal Cord Injury Service at Austin Health at the earliest possible time and ideally in less than six hours.
Patients in whom it is unlikely that other significant trauma can be confidently excluded will be referred to an MTS. A significant proportion of SCI patients have coexistent multisystem injuries, in particular upper thoracic and intracranial injuries.
The transfer and retrieval response will be managed according to patient need after 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.
In liaison with ARV clinicians, interventions to stabilise the patient prior to retrieval personnel arriving should be commenced. ARV will coordinate the 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 in order 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