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he intrahospital and interhospital transfer of critically ill patients is an inevitable part of emergency department practice. Critically ill patients have a high risk of morbidity and mortality during transport. This article reviews current recommendations for the transfer of critically ill patients, with a particular focus on pre-transfer stabilisation, hazards during transport and the personnel, equipment and communica-tions necessary throughout the transfer process. Transfers can be primary or secondary. In the UK, primary transfers to hospital from a prehos-pital site of illness or injury are commonly the responsibility of the ambulance service. These systems may be supported or supplemented b