Safe Transfers - Dr Alistair Hellewell explores the challenges of safely transferring Aortic Dissection patients to specialist care.
When an Aortic Dissection patient needs specialist treatment elsewhere, getting them safely from one hospital to another can be a critical part of their care. Dr Alistair Hellewell explains the challenges of time-critical transfers and how specialist teams prepare patients, manage risk and respond to deterioration.
For some people experiencing an Aortic Dissection, diagnosis is only the beginning of the emergency. The hospital where they first arrive may not provide the specialist treatment they need, meaning they must be stabilised and transferred — sometimes over considerable distances — to another centre.
In this presentation from our 2026 Annual Patient Event, Dr Alistair Hellewell, Clinical Director for Retrieve, the adult critical care transfer service for the South West of England, explains what happens behind the scenes when a critically ill patient needs to be moved between hospitals.
While Retrieve transfers patients with many different illnesses and injuries, acute Type A Aortic Dissection presents particular challenges. Rapid diagnosis and referral must be followed by careful preparation and a safe, time-critical journey to the specialist team able to provide definitive treatment.
In this talk
- Speaker: Dr Alistair Hellewell
- Role: A&E Doctor, South Western Ambulance Service
- Event: Annual Patient Event 2026, Birmingham
- Topics: Patient Transfer · Stabilisation · Aortic Dissection · Teamwork · Resource Coordination · Clinical Decision-Making
More than an ambulance journey
Safely moving a critically ill patient between hospitals involves considerably more than arranging transport.
Before setting off, the transfer team needs to understand the patient’s condition, treatment and physiology; communicate with the teams at both hospitals; prepare the patient for the journey; and anticipate what might happen along the way.
For someone with an acute Type A Aortic Dissection, this can include anti-impulse therapy to control heart rate and blood pressure, alongside planning for the possibility of sudden deterioration.
Alistair explains some of the realities of providing critical care on the road. There are treatments that can be performed in hospital but not in the back of an ambulance, and some interventions cannot safely be undertaken while the vehicle is moving. The team must therefore continually assess the patient and make dynamic decisions throughout the journey.
Communication is equally important. Retrieve can use conference calls to bring together the referring hospital, receiving specialist centre and others involved in the patient’s care, allowing important information and decisions to be shared quickly while the transfer team is on the move.
Keeping the patient at the centre
One of the most thought-provoking parts of Alistair’s presentation concerns the experience of the patient and their family.
A person with a Type A Aortic Dissection may not outwardly appear as critically ill as their diagnosis suggests. They may be sitting up, talking and have relatively little medical equipment around them, yet their condition has the potential to deteriorate catastrophically and without warning.
For the transfer team, the challenge is to maintain the pace required by a medical emergency while still introducing themselves, building trust, explaining what is happening and keeping the patient at the centre of the process.
Alistair also raises an important question for the Aortic Dissection community: what should patients and their families be told about the risks of transfer, and when should those conversations take place?
Different people will want different amounts of information at what can be an overwhelming moment. Alistair argues that listening to patients and families can help transfer services understand how these difficult conversations can be handled better.
He concludes by emphasising the importance of collaboration — between referring and receiving hospitals, transfer teams, clinicians, charities and, crucially, patients and their loved ones. By listening, learning and sharing experience, specialist transfer services can continue to improve the journey for future patients.
