Immediate or secondary transfer?
The key factor behind the decision to transfer from ED to ED as an emergency is whether or not this patient requires a time critical intervention that can only be provided at the MTC.
'Time critical' in this context means within the next 12 hours or so.
Examples of the sort of patients that SHOULD be transferred as an emergency include those needing life or limb saving interventions e.g. evacuation of an EDH, management of vascular limb injuries, management of ongoing haemorrhage that can't be dealt with at the Trauma Unit.
Examples of the sort of patients that SHOULD NOT be transferred as an emergency include haemodynamically stable pelvic fractures, spinal fractures with no neurological injuries. These patients should be admitted to the Trauma Unit in the first instance and transferred secondarily.
There will always be grey cases and you should err on the side of caution - it is better to send then not, but if you wan't to discuss a case then ring the Major Trauma Consultant on call. This is the T&O consultant taking responsibility for admissions and can be contacted via LGI switchboard. An example would be a stable patient with multiple injuries who would be best off at the MTC e.g. multiple rib fractures & splenic laceration & open tibial fracture.
If the patient is still in the trauma unit ED they should be transferred to the MTC ED where they will be received by the trauma team.