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The definition of major trauma for this study was derived from [http://www.selleckchem.com/products/r428.html R428 in vitro] that of the Victorian State Trauma Registry (VSTORM) - Injury Severity Score (ISS) >15, patients admitted to an ICU or high dependency area and who had mechanical ventilation for >24?h, patients with injury as the principal diagnosis and length of stay (LOS) ��48?h, and patients transferred from one study hospital to another for the purpose of definitive care.15?and?16 Patients meeting major trauma criteria and transferred from non-study to study hospitals were also included where data was present in the study hospital record. There were no age limitations. Patients were excluded if they had isolated closed limb fractures only, isolated injuries distal to the wrist or ankle only, soft tissue injuries only, [http://www.selleckchem.com/products/jq1.html JQ1 order] asphyxia or poisoning. A ��transfer phase��, defined for the purposes of this study, had three components: referring hospital (within 30?min of departure), en-route (in the care of the escort) and receiving hospital (within 30?min of arrival). A ��Patient Transfer Form�� (PTF), specifically designed by the principal investigator, was reviewed and revised following comment from the steering committee, co-investigators, participating hospitals and organisations. It was further revised after a pilot phase at study commencement. The form had colour-coded sections for each component of the transfer phase and included separate sections for hospital data, escort type, source and timing data, physiological data, event data and procedures performed during each of the three components. Data included basic demographics, date and time of injury where this was documented (or time of first ambulance call), referring and receiving hospital names, ambulance and time point data, nature, seniority and source [https://en.wikipedia.org/wiki/E-64 E-64] of the escort and monitoring data. Physiological data was recorded on arrival at the referring hospital and upon departure from the referring hospital, en-route and within 30?min of arrival at the receiving hospital. Defined adverse events (arrhythmias, hypotension, hypoxia and lines or tube events) and specific interventions performed were documented for each of the three transfer component periods. The PTF was distributed to all participating organisations. Instructional sessions were conducted to promote compliance and data accuracy. This study was entirely separate from, and unrelated to, the Victorian State Trauma Registry (VSTORM) data gathering process, however VSTORM regional data co-ordinators facilitated PTF distribution and acted as local liaisons in regional areas. This co-operative approach reduced costs and significantly aided the logistics of gathering data on a statewide basis. It was intended that personnel directly involved with each component of the transfer would complete the respective section of the PTF contemporaneously.