Trauma handover practices between ambulance clinicians, emergency department staff and trauma teams: scoping review

BACKGROUND: Effective handovers between paramedics and emergency department (ED) or trauma teams are crucial for safe trauma care. However, communication challenges and system-level barriers can disrupt this process. This scoping review explores the current evidence on trauma handovers to identify key challenges, effective strategies, and areas for improvement. METHODS: This review followed Arksey and O’Malley’s five-stage framework and adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines. A systematic search of five electronic databases was conducted to identify studies focusing on trauma handovers between paramedics and emergency department staff. Fourteen studies were included, employing diverse methodologies including quantitative, qualitative, mixed methods, and multi-method designs. Data were charted and thematically analysed to identify overarching themes and subthemes. RESULTS: Three major themes were identified: (1) challenges in communication (2), strengthening handover practices, and (3) the impact of handover quality on patient outcomes. Subthemes included disruptions and distractions, inconsistent communication frameworks, barriers to collaboration, the standardisation of handover tools, and education and training initiatives. Across included studies, structured communication tools were associated with improvements in handover efficiency, fewer communication errors and omissions, and better team coordination; however, the evidence base was heterogeneous and largely observational. Nonetheless, barriers such as inconsistent adoption, insufficient formal training, and infrastructural limitations were recurrent. Notably, most studies originated from a few countries, including the United States, Canada, and Iran, leaving gaps in understanding trauma handovers in other settings. CONCLUSIONS: Standardised communication tools, targeted training, and stronger collaboration emerge as important strategies for improving trauma handovers. Future research should address gaps in training, tool adoption, and global representation, and explore context-sensitive and digital strategies to enhance handover practices. CLINICAL TRIAL NUMBER: Not applicable.