Northern Regional Trauma Network

  1. These criteria should prompt bypass or immediate transfer to definitive care facilities. Startship (paeds) and
    Auckland (adults) is the definitive care facility for most multi–trauma.
  2. This is a guideline only. It does not replace clinical judgement.
  3. All transfers must be safe and confer clinical benefit to the patient.
  4. Notification between senior transferring and accepting medical staff precedes all transfers.
  5. These guidelines have been agreed by all involved clinicians and endorsed by the four Northern Region CMOs.

Trauma inter-hospital transfer guidelines for Auckland and Starship Hospital

ConditionGo ToRegional referral centre P = Paeds

A = Adults

Comment
Traumatic Brain Injury
All brain injuries Starship/Auckland P/A  
Spine
Suspect spinal injury, no motor deficit Starship/Auckland P  
Spinal cord injury:
• Isolated with motor deficit
• Multitrauma but not TBI or chest injuries
Paeds – Starship
Adults – Middlemore
P Refer to Supra-regional Spinal Cord Injury
Guidelines
Spinal cord injury – with other major injuries such as TBI or chest Starship/Auckland or
Middlemore
P/A Adults – determine whether appropriate to transfer to Middlemore Hospital
Vascular Injuries
Blunt Carotid/Vertebral Injuries Starship/Auckland P/A  
Burns/Plastics
Burns > 20% or less but affects special sites Middlemore   Refer to Burn Guideline
D/w Burn Service at Middlemore on 09 250 3800, and fax referral to 09 276 0114
Burns <20%     Refer to Burn Guideline
D/w Burn Service at Middlemore if grafting required
Degloving of face or other special sites or extensive / complex facial lacerations Middlemore   D/w Plastic Surgical Registrar at Middlemore on 021 784 057
Maxillo Facial
All Max Fax injury – Paeds Starship P D/w Max Fax at Middlemore
Isolated Max Fax injury – Adults Auckland   D/w Max Fax (021 292 1593) or Plastic Surgical
Registrar (021 784 057) at Middlemore
Max Fax injury with TBI or chest injuries – Adults Auckland A D/w Max Fax at Middlemore
Chest
All chest injuries Starship/Auckland P/A  
Abdominal Injuries
All abdominal injuries Starship/Auckland P/A  
Special limb injuries
Upper limb with major nerve injury, +/- arterial injury Middlemore   Call Plastic Surgical Registrar at Middlemore on
021 784 057
Upper limb with arterial injury (but no nerve injury) Starship/Auckland P/A  
Upper limb - amputation of viable digit (excluding simple terminalisation) or partial limb amputation Middlemore   Call Plastic Surgical Registrar at Middlemore on
021 784 057
Mangled lower limb with tissue loss Middlemore   Refer to Mangled Limb Algorithm.
D/w Orthopaedic Registrar at Middlemore on
021 594 764
Lower limb - penetrating injury with major nerve injury +/- arterial injury Middlemore   Call Plastic Surgical Registrar at Middlemore on
021 784 057
Lower limb
• penetrating injury with arterial injury (but no nerve injury)
• blunt injury with ischaemia +/- nerve injury
  P/A  
Orthopaedic
All orthopaedic injuries Starship/Auckland P/A  
Urology
All urology injuries Starship/Auckland P/A