Hospital pre-alert and handover

North of Scotland major trauma guidelines
NHS Grampian

Pre-hospital trauma triage

The ambulance service will use the Pre-hospital Triage Tool to determine the appropriate destination for the trauma patient at the roadside.

The ambulance will provide an ATMIST handover using the form below over the airwaves radio system or red phone to the receiving hospital. If the EMRS trauma team have been involved, the consultant will pre-alert the SPOC phone 01224 5(59031)

The pre-alert form (below) and the ambulance PRF must be placed in the patient notes.

Pre-alert form

Pre-alert information

Record the following information during the pre-alert from the Scottish Ambulance Service (SAS).

  • Age and sex of the injured person
  • Time of incident
  • Mechanism of injury
  • Injuries suspected
  • Signs, including vital signs, and GCS
  • Treatment so far
  • Estimated time of arrival (ETA)
  • Special requirements
  • Ambulance call sign
  • Name of person taking the call
  • Time of the call

Pass the pre-alert form to the Trauma Team Leader (TTL) or senior nurse who will determine the level of trauma team response according to the trauma team activation protocol.

Aberdeen emergency department pre-alert form

Tiered trauma team response

ARI operates a 2-tiered multidisciplinary trauma team response:

ARI major trauma triage tool

  1. Place Tannoy call stating which team is activated.
  2. Dial 2222 if activating either standard trauma or code red trauma teams. Specify hospital and whether adult or paediatric trauma call.
  3. For CODE RED TRAUMA CALLS – The Nurse in charge or Trauma Team Leader will nominate who dials 2222. If a pre-hospital team has given RBC, they can request CODE RED activation. This can be done via 2222 by the trauma team leader prior to the patient's arrival i.e., no patient BTS sample required. If the patient is already in hospital (not had pre-hospital blood) the TTL can activate the MASSIVE HAEMORRHAGE PROTOCOL via 2222 which will require patient BTS blood sample.

Code red response

Activate the Code Red Trauma Team if the patient has any of the following:

  • Systolic Blood Pressure (BP) <90mmHg
  • Absent radial pulse
  • Respiratory rate <10 or > 29
  • Glasgow coma score <14 * (isolated head injury may not require code red).

Code red protocol for Aberdeen Royal Infirmary

Aberdeeen royal infirmary code red protocol

Adult major haemorrhage protocol Aberdeen

SAS handover to hospital

  • The TTL should be easily identifiable for receiving handover.
  • Address immediate life-threatening pathology before handover.
  • Handover should use ATMIST format.
  • Handover should take no more than 30 seconds.
  • Communicate further relevant information to the TTL or scribe later.

Stopwatch displaying '30 seconds'

ATMIST handover