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The need for standards for inter‐hospital transfer

In the last 5 years, since the publication of the Working Party Report from the Royal College of Surgeons of England [ 11, trauma care has received much attention. The demand for Advanced Trauma Life Support courses [2] has outstripped their availability, and Trauma Anaesthesia and Critical Care has been proposed as a subspecialty [3]. Nevertheless, interhospita1 transfer of the trauma patient has remained a neglected area. The responsibility for escorting critically ill or injured patients is often devolved (or abrogated) to junior staff without providing them with any specific training. We support the concept of minimal standards for the care of the surgical patient undergoing anaesthesia in the relatively safe environment of the operating theatre [4]; yet we allow inexperienced junior staff to attend to unconscious, potentially unstable major trauma patients with limited equipment in a dimly lit ambulance travelling at high speed. This situation must change.