Summary
The location of care for many brain-injured patients has changed since 2012 following the development of
major trauma centres. Advances in management of ischaemic stroke have led to the urgent transfer of many
more patients. The basis of care has remained largely unchanged, however, with emphasis on maintaining
adequate cerebral perfusion as the key to preventing secondary injury. Organisational aspects and training for
transfers are highlighted, and we have included an expanded section on paediatric transfers. We have also
provided a table with suggested blood pressure parameters for the common types of brain injury but
acknowledge that there is little evidence for many of our recommendations. These guidelines remain a mix of
evidence-based and consensus-based statements. We have received assistance from many organisations
representing clinicians who care for these patients, and we believe our views represent the best of current
thinking and opinion. We encourage departments to review their own practice using our suggestions for audit
and quality improvement.