Transfer of a critically ill coronavirus disease patient




personal protective equipment (PPE)

How to Cite

sulistio septo, Habib H, Mulyana R, Albar I, Prabowo Y, tjhia J, Purawijaya H. Transfer of a critically ill coronavirus disease patient: Transfer of critical COVID-19 patient. Australasian Journal of Paramedicine [Internet]. 2020Nov.10 [cited 2022Jan.21];17. Available from:


Coronavirus disease (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Acute respiratory distress syndrome (ARDS) is a feature of SARS-CoV-2, and transferring patients with severe ARDS is challenging owing to their condition and risk of infection during the transfer process.

The hemodynamic instability of critically ill patients adds to the challenge of safe transfer, which requires thorough preparation of personnel, medication, equipment, and communication and transport methods, all of which must be organised within the infection control framework.

In this case report we discuss a woman, 37 years of age, with suggested COVID-19, intubated due to severe ARDS. Owing to the hospital referral policy in Indonesia, the patient was transferred to a specialist infectious disease hospital by land ambulance, with a special transfer team formed to adhere to infection control protocols and critical patient transfer procedures.


Gorbalenya AE, Baker SC, Baric RS, et al. The species severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol 2020;5:536-44.

Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;6736:1-10. doi:10.1016/S0140-6736(20)30183-5

Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA 2020;323:1061-9. doi:10.1001/jama.2020.1585

Kementerian Kesehatan Republik Indonesia, Direktorat Jenderal Pencegahan dan pengendalian penyakit (P2P). Pedoman pencegahan dan pengendalian coronavirus disease (COVID-19). Revisi ke-4. Jakarta: Kementerian Kesehatan RI. Maret 2020; p.136. Available at: [Accessed 8 April 2020].

World Health Organization [Internet]. Rational use of personal protective equipment for coronavirus disease 2019 (COVID-19): interim guidance [updated 19 March 2020]. Available at: [Accessed 1 April 2020].

Kementerian Kesehatan Republik Indonesia. Peraturan menteri kesehatan nomor 27 tahun 2017: pedoman pencegahan dan pengendalian infeksi di fasyankes. Available at: [Accessed 8 April 2020]. [Internet]. Washington DC: United States Environmental Protection Agency. List N : products with emerging viral pathogens and human coronavirus claims for use against SARS-CoV-2 [updated 14 May 2020]. Available at: [Accessed 8 April 2020].

Mehta P, McAuley DF, Brown M, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet 2020;395:1033-4. doi:10.1016/S0140-6736(20)30628-0

Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome: the Berlin definition. JAMA 2012;307:2526-33. doi:10.1001/jama.2012.5669

Sethi D, Subramanian S. When place and time matter : how to conduct safe inter-hospital transfer of patients. Saudi J Anaesth 2014;8(1). doi:10.4103/1658-354X.125964

Luster J, Yanagawa FS, Bendas C, Ramirez CL, Cipolla J, Stawicki SP. Interhospital transfers: managing competing priorities while ensuring patient safety. In: Firstenberg MS, Stawicki SP, editors. Vignettes in patient safety, Vol 2. Croatia: Intech; 2018, p.85–104. doi:10.5772/intechopen.72022

Droogh J, Smit M, Absalom A, Ligtenberg J, Zijlstra J. Transferring the critically ill patient: are we there yet? Crit Care 2015;19:62. doi: 10.1186/s13054-015-0749-4

Aitken P, Elcock M, Ballard N, Hooper M. Retrieval and transport. In: Nutbeam T, Boylan M, editors. ABC of Prehospital Emergency Medicine. Oxford: Wiley-Blackwell 2013; p.174.

Ministry of Health of Republic of Indonesia. Pedoman Teknis Ambulans. Available at: [Accessed 6 April 2020].

Pemerintah Provinsi DKI Jakarta. Peraturan gubernur provinsi Daerah Khusus Ibukota Jakarta no 120 tahun 2016 tentang pelayanan ambulans dan mobil jenazah. Available at: [Accessed 8 April 2020]. [Internet]. Atlanta: Centers for Disease Control and Prevention. Public health guidance for community-level preparedness and response to severe acute respiratory syndrome (SARS), version 2 [updated 3 May 2005]. Available at: [Accessed 1 April 2020].

Slattery D, Silver A. The hazards of providing care in emergency vehicles: an opportunity for reform. Prehosp Emerg Care 2009;13:388-97. doi:10.1080/10903120802706104

Chadkirk R, Gander B. Performing cardiopulmonary resuscitation during ambulance transport: safety and efficacy. Resuscitation 2017;116:e15. doi:10.1016/j.resuscitation.2017.04.027