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Critical care interfacility transfer — DipIMC MCQ

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ModerateRetrieval MedicineCritical care interfacility transferDipIMC

A 40-year-old woman with severe sepsis is being transferred from a small community hospital to an ICU 70 miles away. She is on noradrenaline, oxygen and has a lactate of 6 mmol/L. What is the most appropriate immediate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Stabilise airway, breathing, circulation, monitoring and drug infusions before departure

Critically ill retrieval requires preparation before departure, including monitoring, secure access, oxygen, power, infusion continuity and contingency plans. Stopping vasopressors during transfer risks cardiovascular collapse. Waiting for lactate normalisation may delay definitive ICU care. The pearl is that retrieval risk is often highest during packaging and transitions.

Reference: JRCALC Guidelines 2025; Intensive Care Society Transfer Guidance