Transfer of the Critically Ill Adult

These guidelines have been produced as a collaboration between the Intensive Care Society (ICS) and the Faculty of Intensive Care Medicine (FICM). They follow three previous editions of similar guidelines produced by the ICS.

As with the previous guidelines, the intention is to provide colleagues with up to date evidence based advice and to promote high standards of care during the transfer of critically ill patients. 

Prior to developing the guidelines, data relating to transfer activity was obtained from the Intensive Care National Audit and Research Centre, The Scottish Intensive Care Society Audit group and from Critical Care Operational Delivery Networks in England, Wales and Northern Ireland.

A systematic literature review was carried out to identify articles relating to transfers published since the previous edition of the ICS guidelines was prepared.

As previously, the quality of published evidence relating to transfers is poor comprising mostly case series from single centres. Recommendations are therefore based on a combination of available evidence, expert opinion and advice from patient representatives.

Transfer of Critically Ill Patients to the Outdoors

The purpose of this document is to provide staff with guidance on how to safely transfer patients into an outside environment, with the aim of improving their quality of life and long-term outcomes. It must be used in conjunction with our guidance on the Transfer of the Critically Ill Adult.

A prolonged stay in critical care has far reaching consequences for the patient and their family, causing both long term physical and psychological consequences including (but not limited to) post-traumatic stress disorder, muscle loss, fatigue, and anxiety. Drawing on evidence from public green spaces and other hospital settings, exposure to greener environments is likely to reduce anxiety and stress, common psychological conditions which can develop as a response to a prolonged stay in critical care.