Transporting the adult critically ill patient

More than 10,000 intensive care patients are transferred each year in the UK, of whom the vast majority are accompanied by staff from the referring hospital. The high frequency of transfer of critically ill patients is primarily due to the escalating complexity of healthcare, the concentration of skills into specialized regional centres, and the relative lack of availability of intensive care unit (ICU) beds. The care practised during the constraints of patient transfer (whether within or between hospitals) should attempt to mirror the detailed attention provided in the hospital ICU, and it is the responsibility of the transport team to ensure the efficacy of the process and safety of the patient. This is achieved through careful preparation and planning and preparation starts with adequate and appropriate training of transfer personnel as well as selection of equipment which is fit for purpose. Success is based on anticipation and prevention of potential complications and hazards to the patient and transfer team. This article gives an overview of the hazards, organization, and planning of patient transfers, and highlights the importance of interdisciplinary teamwork, good communications, and appropriate decision-making. It also discusses special situations encountered in the transfer or retrieval of patients with complex needs, such as those requiring intra-aortic balloon counterpulsation or extracorporeal membrane oxygenation.