Northern Regional Trauma Network
- 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.
- This is a guideline only. It does not replace clinical judgement.
- All transfers must be safe and confer clinical benefit to the patient.
- Notification between senior transferring and accepting medical staff precedes all transfers.
- 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
|Condition||Go To||Regional referral centre P = Paeds
A = Adults
|Traumatic Brain Injury|
|All brain injuries||Starship/Auckland||P/A|
|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
|Spinal cord injury – with other major injuries such as TBI or chest||Starship/Auckland or
|P/A||Adults – determine whether appropriate to transfer to Middlemore Hospital|
|Blunt Carotid/Vertebral Injuries||Starship/Auckland||P/A|
|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|
|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|
|All chest injuries||Starship/Auckland||P/A|
|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
• penetrating injury with arterial injury (but no nerve injury)
• blunt injury with ischaemia +/- nerve injury
|All orthopaedic injuries||Starship/Auckland||P/A|
|All urology injuries||Starship/Auckland||P/A|