There should be designated consultants in referring hospitals and neuroscience units with overall responsibility for the organisation, infrastructure and processes to enable safe transfer of patients with a brain injury.6
Preoperative assessment clinics should ensure that the patient is optimised as best as possible for elective neurosurgery, e.g. for correction of anaemia, as this can reduce the length of stay, need for blood transfusion and postoperative morbidity.25
The department should consider having a mobile phone available to staff for transfers of brain injured patients.6 Transferring team should have access to mobile phones with the relevant contact details during the transfer to enable them to communicate with the receiving unit if required.
In cases of pregnant orthopaedic trauma patients diversion to a major trauma centre directly from the scene of an injury should be considered, to avoid delay of appropriate specialist care.47
Hospitals should have local guidelines for when a patient dies in theatre or recovery. This should include arrangements to maintain dignity for the patient and to give relatives the best support possible. It should also include arrangements to minimise the impact on other patients being treated in the theatre complex.66
All handovers should contain representatives for the multidisciplinary teams from both theatre and the receiving area and should be documented and structured to ensure continuity of care.65
Appropriate clinical policies, checklists and standard operating procedures for operating theatres should be in place.
The following policies should be immediately and reliably available at sites where anaesthesia and sedation are provided:
