Introduction

In-hospital transfers are required for movement of critically ill patients around the hospital; numerous therapeutic and diagnostic aids now help in the management of critical illness but many of these cannot be brought to the intensive care unit (ICU). Examples include surgical interventions in the operating theater, non-mobile diagnostic aids such as CT scanning, magnetic resonance imaging (MRI), cardiac catheterization, and angiography. Occasionally, journeys outside the ICU must be undertaken for non-operative therapy such as radiotherapy for relief of neoplastic compression of the airway or suppression of new bone formation following repair of acetabular fractures.

The aim of in-hospital transfer is to move the intensive care environment with the patient so that the transfer can be considered as an extension of the critical care continuum in a different part of the hospital.

The equipment required for in-hospital transfers is similar to that needed for interhospital transfer. Indeed, to avoid duplication of equipment and maximize staff familiarity with one standard equipment inventory, institutions may elect to use their interhospital mobile ICU for in-hospital transfers. Transfer equipment for in-hospital use only need not have such long battery life as wall-mounted a.c. supplies should be available at the destination. The in-hospital system may need to carry less emergency equipment, such as a d.c. defibrillator, as these should be available throughout the hospital. As the patient remains in hospital, there is the option of using bed-mounted systems which do not satisfy the size and weight restrictions imposed in interhospital transport by land or air.

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