SECTION I - SUMMARY AND RECOMMENDATIONS
1. High quality transfer of patients with brain injury improves outcome.
2. There should be designated consultants in the referring hospitals and
the neuroscience units* with overall responsibility for the transfer of
patients with brain injuries.
3. Local guidelines on the transfer of patients with brain injuries
should be drawn up between the referring hospital trusts, the
neurosciences unit and the local ambulance service. These should be consistent with established national guidelines. Details of the transfer of responsibility for patient care should also be agreed.
4. While it is understood that transfer is often urgent thorough resuscitation and stabilisation of the patient must be completed before transfer to avoid complications during the journey.
5. All patients with a Glasgow Coma Scale (GCS) less than or equal to 8 requiring transfer to a neurosciences unit should be intubated and ventilated, as should any patients with the indications detailed in Appendix 1.
6. Patients with brain injuries should be accompanied by a doctor with appropriate training and experience in the transfer of patients with acute brain injury. They must have a dedicated and adequately trained assistant. Arrangements for medical indemnity and personal accident insurance should be in place.
7. The standard of monitoring during transport should adhere to previously published standards.[1]
8. The transfer team must be provided with a means of communication - a mobile telephone is suitable.
9. Education, training and audit are crucial to improving standards of transfer.
* Throughout this document the term acute neuroscience unit is taken to include neurology, neurosurgery, neuroanaesthesia, neurocritical care and neuroradiology.
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