Transporting intubated patients, whether within or between facilities, is a complicated process that requires speed, close monitoring, and optimized infrastructure to minimize risk. Inter-facility transfers are often necessary when specialized interventions, diagnostics, or critical care capacity are unavailable at the referring facility (1). Moving intubated patients between departments in the same facility, such as from the OR to critical care, may also be necessary. Movement introduces the potential for adverse events related to patient instability, environmental limitations, or technical failure. The literature emphasizes that successful transport depends on meticulous preparation, structured communication, and continuous risk assessment (2).

Effective communication is fundamental to safely moving patients, intubated or not. Handovers between healthcare teams must convey vital details, including ventilator settings, hemodynamic parameters, and recent interventions. Miscommunication or incomplete information can lead to delayed responses and increased morbidity. The use of structured handoff frameworks, such as SBAR (situation, background, assessment, recommendation), has been shown to improve clarity and reduce preventable mortality by standardizing communication across disciplines (3).

Stabilization and pre-transport optimization are equally crucial. Studies suggest that up to half of all patients transferred between hospitals are on ventilators, and many experience transient desaturation or blood pressure fluctuations during transport (4). Prior to departure, the patient’s physiological status must be stabilized, sedation adjusted, and airway security verified. The nurse in charge should develop contingency plans for potential airway obstruction or circulatory collapse. In their 2023 study, Almqvist et al. highlight that acting calmly and methodically allows for greater patient safety than succumbing to time pressure from referring clinicians (2). Rushed departures often lead to avoidable deterioration during transport.

Technical preparedness is also an essential determinant of safety. Equipment such as ventilators, monitors, and infusion pumps must be reliable. Nonetheless, equipment failures still occur in approximately 15% of interhospital transports, making emergency preparedness essential (5). Vital steps to perform include systematic checks of respiratory and monitoring systems before movement, securing adequate medication supplies, and ensuring power backup capacity. Staff familiarity with transport ventilators and suction devices directly impacts their ability to respond effectively during emergencies. A lack of confidence or competence with this technology is a common source of stress among transport nurses (2).

Finally, professional self-awareness and adaptability are indispensable. The clinician leading a transfer must recognize their limitations, know when to request assistance, and monitor the patient’s condition throughout the journey. Anticipatory mental modeling, or considering “what if” scenarios, helps maintain readiness for airway or hemodynamic crises. Safe patient movement depends on more than just equipment and checklists—it also depends on the clinical team’s capacity for proactive judgment, humility, and clear communication under pressure (2).

Safely moving an intubated patient demands an integrated approach that encompasses thorough preparation, effective communication, rigorous technical verification, and clinical self-awareness. Adhering to structured handoff methods, pre-transfer stabilization, and disciplined equipment management can significantly reduce adverse incidents.

References

1. Eiding H, Kongsgaard UE, Olasveengen TM, Heyerdahl F. Interhospital transport of critically ill patients: A prospective observational study of patient and transport characteristics. Acta Anaesthesiol Scand. 2022;66(2):248-255. doi:10.1111/aas.14005
2. Almqvist D, Norberg D, Larsson F, Gustafsson SR. Strategies for a safe interhospital transfer with an intubated patient or where readiness for intubation is needed: A critical incidents study. Intensive Crit Care Nurs. 2023;74:103330. doi:10.1016/j.iccn.2022.103330
3. De Meester K, Verspuy M, Monsieurs KG, Van Bogaert P. SBAR improves nurse-physician communication and reduces unexpected death: a pre and post intervention study. Resuscitation. 2013;84(9):1192-1196. doi:10.1016/j.resuscitation.2013.03.016
4. Lyphout C, Bergs J, Stockman W, et al. Patient safety incidents during interhospital transport of patients: A prospective analysis. Int Emerg Nurs. 2018;36:22-26. doi:10.1016/j.ienj.2017.07.008
5. Droogh JM, Smit M, Hut J, de Vos R, Ligtenberg JJ, Zijlstra JG. Inter-hospital transport of critically ill patients; expect surprises. Crit Care. 2012;16(1):R26. Published 2012 Feb 12. doi:10.1186/cc11191