Curriculum Resources

Stage 1 and 2 Neuroanaesthesia

Initial Stabilisation, Referral, and Transfer of a Patient with a Severe Acute Brain Injury

Published on 17 March, 2022

Last modified on May 17th, 2023

Curriculum Reference

13.9.5 Provides safe care for ASA 1-3 adult patients with multiple injuries from arrival in hospital to post- operative care and seeks help appropriately.

13.9.5 Applies physiological & pharmacological principles to reduce the risk of secondary brain injury in patients presenting with a severe head injury.

13.9.5 Describes the anaesthetic-related problems associated with trauma including burns, poisoning, electrical injuries, and drowning.

13.11.1 Independently cares for critically ill adult patients during inter-hospital transfers by road.

13.11.6 Manages inter–hospital transfers of adults and children by land, including time-critical transfers, in line with local and regional policy.

13.11.7 Manages the resuscitation, stabilisation and transfer of patients with acute neurological deterioration.

HiLLO 12: Doctors specialising in Intensive Care Medicine understand the special needs of, and are competent to manage patients with neurological diseases, both medical and those requiring surgery, which will include the management of raised intracranial pressure, central nervous system infections and neuromuscular disorders.

HiLLO 7: 7. Specialists in Intensive Care Medicine can provide pre-operative resuscitation and optimisation of patients, deliver post-operative clinical care including optimising their physiological status, provide advanced organ system support and manage their pain relief. 

HiLLO 10: Intensive Care Medicine specialists will have developed the necessary skills of induction of anaesthesia, airway control, care of the unconscious patient and understanding of surgery and its physiological impact on the patient. 

Relevant Review Articles

Transfer of the critically ill adult patient: BJA Education 18(3) 63-68

Bucher J, Koyfman A. Intubation of the neurologically injured patient. J Emerg Med 2015;49:920–927

National Guidance/Standards

Association of Anaesthetists Safe transfer of the brain-injured patient: trauma and stroke, 2019

AAGBI: Safer pre-hospital anaesthesia 2017:

An alternative link to the current transfer recommendations

Association of Anaesthetists of Great Britain and Ireland: Anaesthesia 2017;72:379–390

FICM Transfer of the critically ill patient

pre hospital TBI guideline


e-learning for anaesthesia Module 03: Introduction to critical care – transfer

Online Resources

Intercollegiate Stroke Working Party. National Clinical Guideline for Stroke. 5th ed. London: Royal College of Physicians; 2016

Paediatric Retrieval (from the Evelina, London)

RCoA Audit Compendium

Chapter 12 – Section 2: Transfer of the patient with traumatic brain injury

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