Retrieval of the critically ill in South Australia: a coordinated approach.

A system is described for the stabilization and evacuation of the critically ill in South Australia, with a discussion of experience in 278 patients. The integration of activities of peripheral medical practitioners, major teaching hospitals, and the ambulance transport authority (St John Ambulance Council) is paramount. Modes of communication are by "urgent line" telephone and radio. Advanced life-support equipment is portable, may be placed in any ambulance vehicle, and is used and maintained principally by the staff of intensive care units. The design characteristics of a suitable road vehicle and fixed-wing aircraft are considered, with emphasis on dimensions for the particular needs of advanced life-support. The cost of transporting such a patient is approximately two-thirds of an average bed day cost in a public hospital, plus the basic ambulance charge. The number of patients who need such measures is 0.2% of the total number of patients carried by ambulance per annum.