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 are 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. Delaying transfer to obtain laboratory results or imaging studies may simply delay access to definitive treatment.

Hospitals with neurosurgical facilities should manage neurotrauma patients requiring critical care support. All health services are advised to avoid patient deterioration during inter- hospital transfer by the timely and proactive movement of such patients to a MTS. Currently in Victoria, trauma neurosurgical specialist facilities are located at the Royal Melbourne, the Royal Children’s, and The Alfred hospitals.

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 referring hospital. Once retrieval staff arrives on scene, be prepared to give a thorough handover. Retrieval staff will assess the patient prior to transfer and may update care in order to ensure the patient is safe 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 ^{(7, 8)}.