Transfer of the Sickest Patient in the Hospital: When How and by Whom



The practice of transferring critically ill patients is common both within and between medical facilities. Accurate figures for the number of such transfers are hard to obtain in the UK as there is currently no national reporting system; nevertheless, available data suggests roughly 4500–11,000 critically ill patients are transferred between hospitals per annum [1, 2].


Inter-hospital transfer Intensive Care Hazards Patient preparation Escort 


  1. 1.
    Gray A, Gill S, Airey M, Williams R (2003) Descriptive epidemiology of adult critical care transfers from the emergency department. Emerg Med J 20:242–246CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Kue R, Brown P, Ness C, Scheulen J (2011) Adverse clinical events during intrahospital transport by a specialized team: a preliminary report. Am J Crit Care 20:153–161CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Larrey DJ (1814) Memoirs of military surgery and campaigns of the French army. Joseph Cushing/University Press, BaltimoreGoogle Scholar
  4. 4.
    Hains IM, Marks A, Georgiou A, Westbrook JI (2011) Non-emergency patient transport: what are the quality and safety issues? A systematic review. Int J Qual Health C 23:68–75CrossRefGoogle Scholar
  5. 5.
    Safety guideline interhospital transfer (2009) Guideline of the Association of Anaesthetists of Great Britain and Ireland. Interhospital Transfer, AAGBI Safety Guideline | AAGBI. 2015. at
  6. 6.
    Lovell MA, Mudaliar MY, Klineberg PL (2001) Intrahospital transport of critically ill patients: complications and difficulties. Anaesth Intensive Care 29:400–405PubMedGoogle Scholar
  7. 7.
    Flabouris A, Runciman WB, Levings B (2006) Incidents during out-of-hospital patient transportation. Anaesth Intensive Care 34:228–236PubMedGoogle Scholar
  8. 8.
    Parmentier-Decrucq E et al (2013) Adverse events during intrahospital transport of critically ill patients: incidence and risk factors. Ann Intensive Care 3:10CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Droogh JM et al (2012) Inter-hospital transport of critically ill patients; expect surprises. Crit Care 16:R26CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Marx G et al (1998) Predictors of respiratory function deterioration after transfer of critically ill patients. Intensive Care Med 24:1157–1162CrossRefPubMedGoogle Scholar
  11. 11.
    Handy JM, Walsh A, Suntharalingam G (2011) Improved patient safety during critical care transfers resulting from a sustained Network approach. Intensive Care Med S223:0872Google Scholar
  12. 12.
    Bellingan G, Olivier T, Batson S, Webb A (2000) Comparison of a specialist retrieval team with current United Kingdom practice for the transport of critically ill patients. Intensive Care Med 26:740–744CrossRefPubMedGoogle Scholar
  13. 13.
    Transfer course | Critical Care Network in North West London. Retrieved 12/08/2014
  14. 14.
    Belway D, Dodek PM, Keenan SP, Norena M, Wong H (2008) The role of transport intervals in outcomes for critically ill patients who are transferred to referral centers. J Crit Care 23:287–294CrossRefPubMedGoogle Scholar
  15. 15.
    Houghton JO, McBride DK, Hannah K (1985) Performance and physiological effects of acceleration-induced (+ Gz) loss of consciousness. Aviat Space Environ Med 56:956–965PubMedGoogle Scholar
  16. 16.
    Handy JM (2011) Critical care transfers: the lack of information and systemic shortcomings continue. Anaesthesia 66:337–340CrossRefPubMedGoogle Scholar
  17. 17.
    Recommendations for the safe transfer of patients with brain injury (2006) Guideline of the Association of Anaesthetists of Great Britain and Ireland. Transfer of patients with Brain Injury | AAGBI. 2015. at
  18. 18.
    Chesnut RM et al (1993) Early and late systemic hypotension as a frequent and fundamental source of cerebral ischemia following severe brain injury in the Traumatic Coma Data Bank. Acta Neurochir Suppl (Wien) 59:121–125Google Scholar
  19. 19.
    Head injury: triage, assessment, investigation and early management of head injury in infants, children and adults (2007) NICE guidelines [CG56]. Retrieved 18 Aug 2014 available at
  20. 20.
    Salhab M, Farmer J, Osman I (2006) Impact of delay on survival in patients with ruptured abdominal aortic aneurysm. Vascular 14:38–42CrossRefPubMedGoogle Scholar
  21. 21.
    Holt PJ, Poloniecki JD, Loftus IM, Thompson MM (2007) Meta-analysis and systematic review of the relationship between hospital volume and outcome following carotid endarterectomy. Eur J Vasc Endovasc Surg 33:645–651CrossRefPubMedGoogle Scholar
  22. 22.
    Best practice guidelines for the management and transfer of patients with a diagnosis of ruptured abdominal aortic aneurysm to a specialist Vascular Centre. Joint guidelines from College of Emergency Medicine, Vascular Society and Royal College of Radiologists. Retrieved 18 Aug 2014 available at

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Magill Department of AnaesthesiaChelsea and Westminster HospitalLondonUK

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