Clinical Case Database / Category: Clinical Care

Transfer medicine

Publication details

Dr Shahid Iqbal, Dr Mansoor Bangash
Foundation Years Journal, volume 6, issue 8, p.34 (123Doc Education, London, September 2012)


The aim of this article is to focus on the transfer of critically ill patients. A
critically ill patient is generally defined one who requires a level of care
greater than that normally provided on any standard hospital ward i.e. ITU
Level of Care (1-3). Patients on an intensive care or high dependency unit
may be receiving intravenous infusions and/or being monitored by telemetry
and highly qualified nurses. Despite this being the best environment for the
care of these patients, for one reason or another, transferring critically ill
patients from these units to other locations is quite common. These transfers
are not without risks. During transport a patient’s clinical condition can
deteriorate. The patient may suffer arrhythmia, desaturate, have difficulty
ventilating, or suffer cardiac arrest. Furthermore equipment and monitoring
may malfunction or suffer power loss. Therefore it is very important that a thorough assessment of the balance
of risks and perceived benefits of any transfer is made at a consultant level
before the decision to transport is made.

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Dr Shahid Iqbal

Consultant Anaesthetist
Basildon University Hospital
Essex SS16 5NL

Dr Mansoor Bangash

ST 4
Basildon University Hospital
Essex SS16 5NL


1. Intensive Care Society. Intensive Care Society Guidelines for the transport of the Critically ill adult (3rd Edition 2011)
2. Ahmed I, Majeed A. Risk management during inter-hospital transfer of critically ill patients: making the journey safe Emerg Med J 2008;25;502-505
3. Intensive Care Society. Levels of Critical Care for Adult Patients. Intensive Care Society London.UK 2009
4. Easby J, Clarke FC, Bonner S, et al. Secondary inter-hospital transfer of critically ill patients: Completing the audit cycle. Br J Anaesth 2002;89:354
5. Ligtenberg JJ, Arnold LG, Stienstra Y, van der Werf TS, Meertens JH, Tulleken JE, Zijlstra JG. Quality of interhospital transport of critically ill patients: a prospective audit. Crit Care. 2005; 9(4): R446-51.


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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