Introduction

The number of transfers of critically ill patients within and between hospitals has been continuously increasing throughout the entire evolution of intensive care medicine. This is mostly due to the development of highly technical and non-portable diagnostic devices, the escalating complexity of healthcare, the concentration of skills into specialized regional centres and, not uncommonly, a shortage of intensive care beds. The transfer or transport of critical care patients offer the most difficult challenges and require detailed planning, preparation, skill, knowledge and teamwork to achieve success. Even the transport of patients between two departments in one hospital can be hazardous. Arguably, the highest risk is that of ensuring a patent airway and adequate ventilation. This chapter discusses the process of transferring ventilated patients and examines portable ventilators in some detail.

Basic overview of ventilation for transfer or transport

Indications and contra-indications for transfer

Almost invariably, critical care patients are transferred or transported either to a higher level of clinical care or to a diagnostic procedure that will help direct future clinical management. The indications for transfer are therefore clinical and have the ultimate aim of delivering the patient to the most appropriate care or delivering the most appropriate care to the patient.