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To comprehensively examine the inter-hospital transfer of major trauma patients-including the reason for transfer, duration, escorts, interventions and unexpected events. This was an detailed study of the transfer of major trauma cases in the State of Victoria, Australia, between April 16, and December 31, Defined major trauma cases that were transferred between participating hospitals for the purpose of definitive care were eligible for enrolment.
The transfer phase extended from 30 min before until 30 min after the transfer. The transferring and receiving hospitals and the transfer escorts were asked to record data on a specifically designed data collection form. A total of cases were enrolled mean Injury Severity Score Transfers originated mainly from Regional Trauma Median time from injury to arrival at the receiving hospital was 8 h 30 min.
Median time from arrival at referring hospital to request for transfer was 3 h 25 min. Medical escorts were mainly Overall mortality was 6.
HMO escorts had the highest mortality risk OR 3. Mortality risk was greatest for cases that required administration of vasopressor drugs OR Considerable variability in request for transfer and transfer times, transfer escorts and mortality risk exist. The single greatest issue identified that most severely injured group were escorted by the most junior doctors HMOs and had the highest mortality. This crucial issue must be addressed by the State Trauma System and by any redesigned retrieval service in Victoria.
A detailed review of activation and responsiveness criteria and the nature of the transfer escort is indicated.