Service · The highest level
The transfers where
the margin is smallest.
Critical care air transport is the discipline of keeping the sickest patients alive across a journey — where the crew are practising intensivists, the equipment is a full transport ICU, and every decision is a risk calculation made in advance.
Service · The highest level
What this covers.
There is a principle in critical care transport that sounds obvious and is regularly ignored: the level of care during transfer should never be lower than the level of care the patient is receiving in the unit they are leaving. Everything else follows from that.
Meeting it means the crew have to be people who work in intensive care, not people trained to accompany intensive care patients. It means equipment redundancy rather than sufficiency. And it means the decision to transfer at all is a clinical one, weighed against the risk of moving a patient who is stable exactly where they are.
What defines a critical care transfer
- A physician-led crew with current intensive care practice
- Full transport ICU capability with redundancy on every critical system
- Pre-agreed escalation protocols and identified diversion fields along the route
- Referring and receiving intensivists in direct contact before departure
- Continuous documented observation, intervention and medication records
- A structured handover that meets the receiving unit's own admission standard
The risk conversation
Not every critically ill patient should be moved. Transfer carries real risk — physiological, from handling and altitude, and practical, from the loss of a full hospital environment for several hours. Where the benefit of the destination does not clearly exceed that risk, the right recommendation is to wait, or not to move at all, and we will make that recommendation even when it is not what the family wants to hear.
Clinical capability
What the crew
can actually do.
Capability is what separates a critical care transfer from a monitored one. These are interventions the crew are equipped and credentialled to perform in flight.
Intubation, difficult-airway management and ventilator adjustment across modes, with the equipment and drugs to do it safely in a confined cabin.
Vasoactive infusions titrated in flight, invasive pressure monitoring, and fluid and blood product management.
Transport ventilation including lung-protective strategies, and management of chest drains and air leaks at altitude.
Intracranial pressure management, controlled sedation and precise physiological targets for brain-injured patients.
Blood gas and basic biochemistry in flight, so that ventilation and infusions are adjusted on data rather than on impression.
The authority and the plan to divert to a pre-identified field when the clinical picture demands it.
Decision log · Should this patient move?
The most important call
is whether to fly at all.
Before the logistics begin, there is a clinical question that deserves a real answer rather than an assumed one.
What does the destination offer?
A specific capability the current facility lacks, or continuity with a home team. If the answer is only 'closer to family', that is a legitimate reason but it changes the risk calculus.
What could go wrong in transit?
The specific deterioration modes for this patient, how likely each is over the sector length, and whether the crew can manage each one in the air.
Now, or in 48 hours?
Many transfers are safer after a short delay for optimisation. Urgency is often assumed rather than clinically established.
Is there another option?
Whether the required expertise could travel to the patient, or whether a shorter evacuation to a regional centre serves better than a long sector home.
Agreed, and documented
The referring intensivist, the receiving intensivist and the EuropeCair medical team agree the plan, the escalation protocol and the abort criteria before departure.
EuropeCair will decline or defer a transfer where the clinical risk of moving the patient is not justified by the benefit of the destination.
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Questions we are asked
Before you
need us.
If your situation is not covered here, the coordination centre will answer directly, day or night.
Call +44 20 3671 5709The level of intervention the crew can deliver. A monitored transfer observes and responds within a limited scope; a critical care transfer carries a physician-led team able to manage the airway, titrate vasoactive support and make escalation decisions in the air.
Yes. Where the clinical risk of transfer is not justified by the benefit of the destination, the right recommendation is to wait or not to move. That recommendation is made by our medical team in consultation with the treating physician.
The EuropeCair medical team, in consultation with the treating physician. For critical care cases the receiving intensivist is part of that conversation too.
The crew treats within their full scope, and the aircraft diverts to a pre-identified field if the clinical picture requires it. Diversion options are established before departure, not searched for in the moment.
The mission can. The clinical negotiation between three sets of doctors, and the stabilisation the patient may need first, are the parts that take time — and compressing them is usually the wrong economy.
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If a transport is needed now, call the coordination centre. If you are planning ahead, a EuropeCair membership is $600 a year and covers unlimited medically necessary repatriation flights.