Transfer to definitive care

Question 1

Transfer responsibilities of referring doctor to tertiary centre (9)

Answer 1

• initiating transfer during resuscitation
• consulting with the receiving doctor
• maintaining familiarity with transporting agencies
• selecting the appropriate transportation mode
• determining the level of care required during transfer
• stabilising the patient’s condition before transfer
• providing a patient summary
• ensuring that adequately trained personnel accompany patient
• ensuring paediatric patients are transferred to facilities with special expertise, when available

Question 2

Clinical measurements indicating need for transfer to institution with trauma team/surgical ability (5)

Answer 2

• evidence of shock
• significant physiologic deterioration
• progressive deterioration in neurologic status
• stable pts with blunt abdo trauma and liver/spleen injuries who might require urgent operation
• high energy transfer injuries

Question 3

Patient factors that might indicate the need for transfer to tertiary centre (4)

Answer 3

Elderly
Obese pts may need early intubation
Pts under influence of substances in whom cerebral injury is possible
Death of another individual involved in the traumatic incident

Question 4

Treatment during transport to another hospital

Answer 4

Monitor obs
Continue cardiorespiratory support
Fluid resus
Medications
Maintain communications
Maintain accurate records