Introduction; The University Hospital of Trauma, Tirana, Albania, is the only National referent centre for trauma in Albania. The primary care centre for trauma, often operates over the capacity of the trauma patients, limiting access to Emergency surgical care for non-trauma patients.

For non-traumatic surgical emergencies are instructions to inform the patient selection for transfer to another institution such as a University Hospital Centre “Mother Theresa” in Tirana, Albania. Such decisions can be particularly difficult for severely ill patients when transferring benefits are uncertain.

Material and Methods: To point out the role of surgeons at different hospital levels, for transfer, we took a qualitative analysis of cases that are transferred from a regional or municipal hospital to the University Hospital of Trauma...

Results: Surgeons in the regional or municipal hospitals require transfer when the ability to care for the traumatized patient is limited by the lack of necessary staff or equipment, and when the needs for surgical treatment of patients or comorbid conditions are not available at the level of local. Surgeons (non-primary centres) sometimes transfer patients who can be selected at home (Second or third-level hospitals ...) or with fatal safety progress, in order to try all treatment options or to satisfy families by thus reducing the possibility of benefiting from the treatment of other patients.

Conclusion: Decisions on the transfer of surgical patients are complex and require good recognition of traumatized patient assessment protocols, knowledge, and capacity coordination both local and central as well as in logistics, personnel, and scientific and professional levels.

Keywords: Polytrauma, Challenges, Management