Transfer Center


The Queen's Medical Center

Transfer Center
Neurology/Neurosurgery Transfer Criteria

(TRAUMA Requests: Refer to “Head Injury Transfer Guidelines”)

Indication for Transfer Request:
If the referring hospital has the appropriate specialist (neurologist or neurosurgeon) on staff, the Transfer Hotline RN will request that the referring hospital’s specialist speak to the QMC specialist via the Transfer Hotline regarding indications and need for transfer.

If the referring hospital does not have a NEUROSURGEON on staff:

1. Cerebellar hemorrhage with mass effect, especially:*
     a) >3cm
     b) with neurological deterioration
     c) hydrocephalus

2. Supratentorial lobar intracerebral hemorrhage with:
     a) mass effect,
     b) good baseline function AND
     c) lobar <1 cm of the surface.

3. Non-traumatic subarachnoid hemorrhage

4. Intraventricular hemorrhage with hydrocephalus

5. Symptomatic (e. g. new weakness, altered mental status) chronic subdural hematoma with mass effect

If the referring hospital has no NEUROLOGIST on staff:

6. Acute inflammatory demyelinating polyneuropathy (Guillain-Barre) or myasthenia gravis with respiratory compromise requiring plasmapheresis and critical care

7. Status epilepticus


No indication for Transfer Hotline Request:
1. Consultations (use referring hospital’s typical neurology / neurosurgery referral system)

2. Issues that have been on-going for weeks/months (use outpatient referral system)

The following requests should first be evaluated by Transfer Hotline Medical Director.  If Transfer Hotline Medical Director feels it is appropriate, it should then be referred to QMC neurologist or neurosurgeon for discussion before acceptance of transfer.

1. Intraparenchymal hemorrhage without mass effect

2. Comatose patients with brainstem, thalamic, basal ganglia hemorrhage
     a) Follow AHA/ASA guidelines including lowering BP <160/90 andcorrect coagulopathy*.
*Broderick J, et al.  Guidelines for the management of spontaneous intracerebral hemorrhage in adults:  2007 update. Guideline from the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, the Quality of Care and Outcomes in Research Interdisciplinary Working Group.  Stroke 2007;38:2001-2023.

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