ABSTRACT
The requirement to transfer ever increasingly unwell patients has necessitated major advances in patient transfer. This has been driven by the dramatic increase in the survival of the war wounded with major injuries seen in recent conflicts. The advances are particularly noteworthy in the aviation environment, which has always presented serious challenges. Patients who have received injuries which, in the past, would have been seen as most demanding and requiring a high level of escort (Table 43.1), have more recently been treated in different ways to allow less intervention and a reduction in the level of supervision (e.g. the use of peripheral and neuro-axial blockade, advanced chest drainage systems and vacuum wound dressings). Likewise, patients once deemed too unwell to be moved from their bed space within a hospital, have regularly been safely transferred by air over extended timescales and great distances (Figure 43.1).
