Transporting the critically ill patient

More than 10,000 intensive care patients are transferred each year in the UK, of which about 90% are accompanied by staff from the referring hospital. The frequency of transfer of critically ill patients between hospitals has increased since the development of intensive care medicine. This is primarily due to the escalating complexity of healthcare, the concentration of skills into specialized regional centres, and the relative lack of availability of ICU beds.The care practised in the restricted environment of patient transfer (whether within or between hospitals) should at least attempt to mirror the detailed attention provided in the hospital ICU, and is the responsibility of the transport team; this is achieved through careful preparation and planning. Preparation starts with training of the personnel and selection of optimal equipment. Success is based on anticipation and prevention of potential complications and hazards to the patient and transfer team.This contribution 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 focuses on the 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, and looks to the future to examine the challenges and opportunities that lie ahead.