Interfacility Transportation of the Critical Care Patient and Its Medical Direction

Revised and approved by the ACEP Board of Directors April 2012 
Reaffirmed by the ACEP Board of Directors September 2005
This policy statement was originally approved by the ACEP Board of Directors September 1999

The American College of Emergency Physicians (ACEP) believes that a patient's condition and the potential for complications should dictate the level of services available during interfacility transportation. Critical care transport teams are an important means of providing an appropriate level of care during the transfer of critically ill and injured patients.

Sound policies and coordination among the various responsible parties are necessary to provide seamless care for the patient throughout the transfer process. Transferring physicians are responsible for initial patient assessment and determining the appropriate level of care for the patient during transfer. Accepting physicians must ensure that the receiving facility is fully capable of providing necessary patient services and care.

Transportation agency physician medical directors must have sufficient education, experience, and training in the management of critical care patients and in transportation medicine issues to ensure appropriate medical oversight and direction to the transportation agency and its personnel.

Critical care transportation agency physician medical directors should: 

  • Oversee the clinical development and operation of these specialized transfer services, including administrative and relevant clinical guidelines.
  • Determine minimum team composition and equipment requirements.
  • Promote that all team members are properly educated and trained in the critical care transport environment and do not practice outside the scope of practice as approved by the medical director or defined by state statute.
  • Promote adequate orientation to the out-of-hospital environment for personnel who work periodically with regular critical care transportation agency personnel, but do not normally provide out-of-hospital critical care services.
  • Provide consultative services, education, and guidance to physicians, transportation agencies, and others involved with patient transfer decisions.




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