Transport of the critically ill patient is an inevitable and frequent part of critical care practice. The reasons for this are manifold; however, a visit to the radiology department for specialist investigation and/or intervention is probably the most frequent.

The increased risk to patient safety combined with the frequency with which transfers occur has led to the development of local and national guidelines regarding the necessary procedures and precautions that need to be considered before and during patient transfer to minimise the risk of patient harm. The American College of Critical Care Medicine recommends that “a patient should not be transported before airway stabilization if it is judged likely that airway intervention will be needed” during the transfer. The potential risks and complications of inducing anaesthesia, performing tracheal intubation and instituting invasive ventilation in a critically ill patient in an emergency situation are plenty even when tackled in the relative comfort of an ICU. However, to do so in less familiar and more isolated surroundings merely adds layers of technical difficulty and stress and unduly amplifies the risk of possible complications.

The decision to secure a patient’s airway before embarking on transfer to the radiology suite should be made based on three considerations:

In the context of the critically ill patient, it should be emphasised that the only satisfactory method of airway stabilisation is endotracheal intubation. Other methods, such as the use of supraglottic airway devices or simple airway adjuncts are usually only appropriate as rescue techniques to maintain oxygenation in an emergency situation such as failed endotracheal intubation.