Victorian trauma triage and transfer guidelines provide specific physiological and anatomical criteria which prescribe how major trauma patients should be transferred across the trauma system.
The guidelines are designed to assist all health professionals in identifying major trauma patients and appropriate triaging and transferring.
Major trauma triage guidelines
There are three main trauma guidelines in use in Victoria. They describe the activation protocols for the Victorian State Trauma System (VSTS).
Pre-hospital major trauma criteria
These criteria are for the initial clinical assessment and identification of a major trauma patient. This information then guides clinicians and paramedics in communicating with Adult Retrieval Victoria and the VSTS as appropriate.
Ambulance services should triage adult major trauma patients and suspected adult major trauma patients directly to an adult Major Trauma Service (The Alfred or the Royal Melbourne Hospital) when the travel time is less than 45 minutes.
If a Major Trauma Service is not within 45 minutes travel time, then the patient should be triaged to the highest level trauma service within the 45-minute timeframe.
Ambulance services should triage paediatric major trauma patients and suspected paediatric major trauma patients directly to the Royal Children’s Hospital when travel time is less than 45 minutes.
Where the estimated travel time is greater than 45 minutes and the preferred destination is a Major Trauma Service, consultation should occur between the paramedic, Ambulance Victoria clinician and Adult Retrieval Victoria.
Triage guideline requirements
Major trauma triage guidelines require:
- pre-hospital major trauma to be identified according to specified physiological and anatomical criteria
- triage to a major trauma service where a major trauma patient is less than 45 minutes transport time from a major trauma service
- triage to the highest designated trauma service accessible in 45 minutes where a major trauma patient is more than 45-minutes transport time from a major trauma service
- triage to a designated trauma service accessible in the least amount of time in isolated rural areas that are more than 45 minutes from any trauma service
- where a major trauma patient appears to be in an immediately life-threatening situation during transport, the patient is diverted to the nearest designated trauma service for stabilisation, with subsequent transport to a major trauma service at the earliest appropriate time
- where a patient is triaged initially to a non-major trauma service for stabilisation, early liaison with Adult Retrieval Victoria (1300 36 86 61), and consideration given to appropriate medical retrieval or inter-hospital transfer to a major trauma service. Early liaison with the Paediatric Infant Perinatal Emergency Retrieval Service (PIPER) (1300 13 76 50) should occur for all children under 16 years of age
- discrete spinal cord trauma to be triaged to the Austin Hospital
- all spinal trauma in paediatric patients to be triaged to The Royal Children’s Hospital
- all trauma services receiving spinal trauma patients to consult the Victorian Spinal Cord Service early after patient reception to optimise patient outcomes
Specialist trauma guidelines
The following specialist trauma guidelines can be accessed on the Trauma Education website. The Trauma Education initiative is a collaborative project between the Department of Health & Human Services and Adult Retrieval Victoria on behalf of the Victorian State Trauma System.
- The Victorian State Trauma System
- Teamwork and Communication
- Early Trauma Care
- Spinal Trauma
- Traumatic Brain Injury
- The Deteriorating Trauma Patient
- Obstetric Trauma
- Paediatric Trauma (including burns and spinal trauma)
- Preparation for Retrieval.