Objectives

Identify injured patients who may require

transfer from primary facility to trauma
center
Initiate procedures for optimal, safe patient
transfer

Key Questions
What is the problem?
Who do I transport?
Where should I send the patient?
When should I transfer the patient?
How should I transport the patient?

Transfer Principles
Know institutional capabilities
Be prepared, anticipate patient needs
Do no further harm
Identify patients whose needs exceed
local resources
Perform only essential procedures

Transfer Principles
Establish direct communication between
referring and receiving doctors
Transport to closest, appropriate facility
Use most appropriate mode of transport

What is the problem?

What are the patients injuries ?
What additional information is needed
from the prehospital personnel ?
What preparations are necessary?
What are the patients need? Can they
be fulfilled?

Who do I transport?
Multiple-injured patients
Patients whose needs exceed institutional
capabilities
Patients with comorbidities
Extremes of age
Preexisting disease

Where do I send the patient?

To an institution capable of providing
equipment and resources
To an appropriate, qualified surgeon who
can
Make the diagnosis
Manage the patients injuries
Provide commitment and resources

When do I transfer?
After life-threatening problems are
managed
After disabling injuries are stabilized
After transfer is arranged
Before performing unnecessary test and
procedures
Avoid delay!

How do I transport?
Determine by:
Care required en route
Patient destination
Available resources
Existing transfer agreements

 What is the problem? Not all hospitals

can care for all trauma patients
Who do I transfer? Patients whose needs
exceed local resources.
Where should I send the patient? Ideally,
to a verified trauma center.

 When should I transport the patient?

After immediate, life-threatening injuries
are addressed.
How should I transport the patient?
According to the patients needs and
available resources.