An advanced trauma service is the hub of the trauma system. The care is based around a comprehensive (Level III) intensive care unit committed to providing treatment to the injured. The hospital also has many 24 h per 7 day resources and is complete with regard to contemporary diagnostic services. These facilities carry the major responsibility to coordinate trauma services in urban and rural areas, for given regions. Patients are uncommonly referred on, but may be
transferred to a tertiary referral service for management of specific injuries. Advanced trauma service hospitals provide a rapid retrieval and primary response service with in their geographic area. Access for both road ambulance and helicopter is readily available with direct access to the Emergency department. An advanced trauma service is likely to have tertiary referral components and may also have patients referred from other trauma hospitals for management of specific injuries. New Zealand has Advanced Trauma Services based in each of its five metropolitan centres. In Auckland a more complex mix of hospitals (including the Starship Childrens’Hospital) provides advanced services for the metropolitan population and wider catchment of about 1.5 million.