Critical Care Transport

One phone call brings the expertise of Cleveland Clinic physicians, nurse practitioners, critical care nurses, paramedics and allied health to patients in need anywhere at anytime across the globe.

  • Transfer your patient:
    866.547.1467
  • Acute transfer for patient: 877.379.CODE (2633)
  • Global CARE membership: 866.442.5092

Toll-Free: 866.320.4573

We transport critically ill and injured patients via ground mobile intensive care unit, rotor wing aircraft (helicopter), and fixed wing aircraft (jet). Every mode of transport always has an acute care nurse practitioner (ACNP) and/or physician, a critical care flight paramedic and a critical care flight nurse. 

The quality care of Critical Care Transport is provided for infants, children and adults. We staff our units with combinations of personnel based on the needs of the individual patient.

We can obtain specialized consultation with physicians in all specialties at Cleveland Clinic. This communication and seamless transition of care continues throughout evaluation and treatment at Cleveland Clinic.

Volume & Statistics

  • On average our Critical Care Transport Team makes more than 4,500 transports a year.
  • States visited: 44
  • Countries visited: 23
  • Territories visited: 2

Modes of Transport

We care for and transport critically ill and injured adults and children via the following services:

Fixed wing (jet) »

Our fixed wing service eliminates geographic boundaries for access to Cleveland Clinic care. There are currently four fixed wing aircraft (model Citation 5 Ultra) located at Burke Lakefront Airport in Cleveland, Ohio. 

  • Dedicated, medically-configured Cleveland Clinic Aircraft
  • Domestic and International capabilities
  • Cleveland Clinic medical team on every mission
  • Management capabilities include:
    • Full mechanical ventilation
    • Ventricular assist devices
    • Diagnostic imaging
    • Temporary pacemaker
    • Point-of-care lab analysis capabilities including: ABG; blood chemistries; hemoglobin; and hematocrit
    • Invasive line insertion and monitoring including: Swan-Ganz; arterial, central venous and intracranial pressure

Rotor wing (helicopter) »

Cleveland Clinic's Critical Care Transport Team has three Sikorsky S-76 C+ model, dual pilot, IFR-approved, WAAS-capable aircraft with a range of 250 miles with speeds of up to 170 miles per hour. These aircraft are currently based at Cleveland Clinic main campus (Cleveland, Ohio), Richard E. Jacobs Health Center (Avon, Ohio) and Cleveland Clinic Twinsburg (Twinsburg, Ohio). 

This aircraft provides the largest usable interior for medical transport, allowing for the use of cardiac-assist devices while providing room for up to four medical crew members.

Ground mobile ICU»

Two mobile intensive care units are staffed 24 hours a day, 7 days a week. These units provide routine service within approximately 75 miles of Cleveland Clinic main campus.

Non-time-sensitive missions outside of the 75 mile range can be arranged upon request.


Education & Community Outreach

Cleveland Clinic's Critical Care Transport Team is devoted to serving the community. In an effort to provide the highest level of service, we have developed an outreach program to ensure we stay in close communication within the community and with professionals around the world.

Our team is available to provide clinical lectures and programs to physicians, nurses, EMS personnel and first responders. We tailor programs specific to your group’s needs.

If you would like to request our team and/or aircraft for a community event or if you are interested in arranging a speaker at your facility, please contact:

JR Sesock
Outreach Coordinator
Sesockj@ccf.org

Learn More

Critical Care Transport available Domestic and Worldwide

How to Request a Transport »

Acute Care Transfer Line*
*For STEMI, ACUTE CVA, INTRACRANIAL HEMORRHAGE, AORTIC SYNDROMES only.
Call toll-free: 877.379.CODE (2633)

For All Other Transports
Call locally: 216.444.8302
Toll-free: 866.547.1467

Referring providers please have the necessary information to easily request a transport.

Patient Information
  • Name
  • Date of birth
  • Diagnosis
  • Cleveland Clinic medical record number (if available)
  • Location of patient (ED, ICU, CCU) and phone number of referring location 
  • Description of patient’s current medications 
  • Current invasive lines, assistive devices, drips, or needs for telemetry

Be sure to fax the demographic/insurance sheet to: 216.445.7222

Please have your contact information available:

  • Name
  • Address
  • Phone number
  • Fax number
  • Email

Additional Resources»

Online Access to Your Patient's Treatment Progress

Whether you are referring from near or far, our new eCleveland Clinic service, DrConnect, can streamline communication from Cleveland Clinic physicians to your office. This new online tool offers you secure access to your patient’s treatment progress at Cleveland Clinic. With one-click convenience, you can track your patient’s care using the secure DrConnect website.

Direct to Physician

Our 216.444.2200 or 800.223.2273 (outside of Cleveland) operator-assisted number will connect you at the physician’s office. You may also call Patient Access Hospital Transfer Services at 216.444.8302 or 866.547.1467. This direct-access, 24-hour phone line can connect you to a Cleveland Clinic physician.

For More Information

Call toll-free: 800.223.2273, ext. 55580
Visit: clevelandclinic.org/services 
Email: medicalconcierge@ccf.org

Contact Us»

Acute Care Transfer Line*
*For STEMI, ACUTE CVA, INTRACRANIAL HEMORRHAGE, AORTIC SYNDROMES only.
Call toll-free: 877.379.CODE (2633)

For All Other Transports
Call locally: 216.444.8302
Toll-free: 866.547.1467

Acute Ischemic Stroke»

When time is of the essence, Cleveland Clinic’s Critical Care Transport team can rapidly respond to critically ill patients suffering from acute ischemic stroke. Our team works with referring healthcare providers to initiate and maintain state-of-the-art treatment during the transport process to Cleveland Clinic’s Neurological Intensive Care Unit, which is staffed 24/7 by board-certified neurointensivists.

Presentation

A woman in her 70s who was hospitalized for atrial flutter suddenly experienced left-sided weakness, difficulty speaking, limb ataxia and sensory loss. Computed tomography angiography showed an occlusion of the right middle cerebral artery (MCA). Administration of intravenous rtPA and transfer to Cleveland Clinic via its Critical Care Transport team immediately followed.

Upon arrival, her stroke symptoms continued to worsen with a NIH Stroke Scale score of 14. Hyperacute MRI was performed, showing acute ischemic changes in the right caudate nucleus, right lentiform nuclei and right frontal corona radiata. Given the apparently small area of permanently injured brain in spite of her high NIHSS score and the large occlusion in her right middle cerebral artery, the decision was made to bring her to the angiography suite for mechanical thrombolysis and thrombectomy.

Treatment

The patient was brought to the angiography suite. With the patient under conscious sedation, the neurointerventional team rapidly deployed an aspiration catheter and thrombectomy device into the right MCA, disrupting and removing the clot. Blood flow was restored in under five minutes of aspiration.

By the day following the procedure, her neurological exam had improved markedly, with only mild residual difficulty speaking and mild-to-moderate left arm and facial weakness. With a total NIHSS score improved from 14 to 5, she was discharged to a rehabilitation facility.

Outcome and follow-up

On follow-up at six weeks, the patient’s NIHSS score had improved to 3, with mild residual dysarthria, left arm drift and slight facial weakness. She has made a remarkable recovery.

Without the expertise and efficiency of Cleveland Clinic’s Critical Care Transport team, rapid transfer of this patient to a facility with the state-of-the-art resources needed to save neurologic function might not have been possible. Cleveland Clinic’s autolaunch protocol allows our transport team to be en route, even as the patient’s specific case is being discussed between facilities, saving precious time and ultimately neurologic function.

Our Critical Care Transport team functions as a portable version of Cleveland Clinic’s Neurological Intensive Care Unit. This means our skilled CCT team members work with our referring healthcare providers to deliver state-of-the-art, first-line stroke treatment while also stabilizing the patient for transport to Cleveland Clinic for definitive interventional therapy. Our critical care transport system is about having the means and resources to bring Cleveland Clinic expertise to patient bedsides anytime and anywhere in the world – with the goal of improving quality of life for critical care patients.

Acute Type A Dissection & Ischemic Bowel»

More people die each year from aortic disease than breast cancer, homicide, pancreatic cancer, colon cancer, prostate cancer or motor vehicle accidents. Aortic dissection is a true, surgical emergency with high mortality rate. Ninety percent of patients with acute type A aortic dissection who are not treated within the first 48 hours die from the condition. In 2010, Cleveland Clinic performed 257 emergency ascending aorta and arch procedures, and nearly one-third of those were for acute aortic dissection. These procedures are performed by a multidisciplinary team at Cleveland Clinic using a modified hybrid surgical technique that allows for safe repair for the most critical patients presenting with malperfusion.

Presentation

A 76-year-old man called 911 after experiencing an acute onset of back pain followed by bloody diarrhea. He arrived at Euclid Hospital’s (a Cleveland Clinic community hospital) emergency department where he was subsequently found to have an acute type A aortic dissection. The dissection was extensive, extending from the heart into the pelvis resulting in ischemic bowel. The tear had also extended back towards the aortic valve, causing it to leak. Given the risk of aortic rupture, Cleveland Clinic’s Critical Care Transport team was called to bring the patient to Cleveland Clinic for emergent aortic surgery.

Cleveland Clinic’s CCT team kept the patient stable during his transport while communicating with the acute aortic team at Cleveland Clinic so the hybrid operating room could be prepared. Upon arrival at the intensive care unit, care was transferred to the cardiology and anesthesia team, who helped expedite the transition to the operating room. However, immediately upon arriving in the operating room he suffered cardiac arrest, where the team was prepared and waiting. An emergency thoracotomy was performed to relieve the pressure around his heart. Blood had collected in the pericardium resulting in tamponade, and was also leaking out of the aorta. Once he was stabilized, type A dissection and ischemic bowel repair began.

Treatment

The patient underwent a combined/hybrid open heart surgery of his aortic root, including replacement of the valve and repair of the ascending aorta and arch. The cardiothoracic surgery team also performed a stent graft repair of his upper descending aorta. Immediately following, his mesenteric artery was stented by the vascular surgery team, and an exploratory laparotomy was performed by colorectal surgeons. The team worked through the night, with surgeries lasting in excess of 12 hours in the hybrid operating room, a state-of-the-art facility where a multidisciplinary team of surgeons can perform treatment without moving the patient. In this patient’s case, the ability to receive highly specialized care in an expedited fashion was lifesaving.

Outcome and Follow-up

The patient spent several weeks in the hospital following surgery, but his recovery from the near-fatal incident was remarkable. He did not require tracheostomy, dialysis or bowel resection, thanks to the expeditious care provided by the multidisciplinary team, including members from critical care transport, cardiac intensive care unit, cardiothoracic anesthesia, cardiothoracic surgery, vascular surgery, cardiothoracic intensive care unit, cardiovascular imaging and nursing. He regained his strength and the repaired portions of his aorta healed. However, several months later he developed rapid degeneration of a distal segment of his aorta. He subsequently returned for an elective endovascular procedure to stent the damaged segment.

The patient recovered remarkably well. He is grateful for his care and can continue living a healthy life. He is still being regularly followed at Cleveland Clinic to monitor his aorta and help maintain good control of his blood pressure.

Ventricular Fibrillation Arrest»

Cleveland Clinic’s Critical Care Transport (CCT) service has the ability to function as a mobile version of Cleveland Clinic’s intensive care units. Skilled CCT team members work with our referring healthcare providers to deliver Cleveland Clinic ICU care to the bedside, and continue this care during the transport process to Cleveland Clinic for definitive therapy. Our critical care transport system is about having the means and resources to bring Cleveland Clinic’s expertise to the patient’s bedside anywhere in the world and at anytime – reflecting the ideal of “no patient too sick, and no patient too far.”

Presentation

A 59-year-old man was at home with his wife vacuuming when he suddenly collapsed suffering a cardiac arrest. His wife called EMS and immediately initiated CPR. When paramedics arrived, he was defibrillated and intubated.

Upon arrival at Medina Hospital (a Cleveland Clinic community hospital), the patient was actively seizing. He was given lorazepam (Ativan®) and stabilization measures were undertaken by the emergency department physician. The physician at Medina subsequently initiated transfer to Cleveland Clinic’s main campus. However, while being transferred to the helicopter, the patient again suffered cardiac arrest, requiring defibrillation.

Treatment

Upon arriving at Cleveland Clinic, the patient was taken directly to the cardiac catheterization laboratory. Coronary angiogram revealed one-vessel obstructive coronary atherosclerosis, which was treated with insertion of a bare metal stent to the right coronary artery.

The patient was then moved to the coronary intensive care unit, where the hospital’s cooling protocol was initiated. Neurology was consulted and the patient was placed on phenytoin. An EEG was recommended, demonstrating findings consistent with encephalopathy without epileptiform activity.

Post intervention, the patient developed complete right bundle branch block and T wave changes. His peak CPK level was 777, with a CK-MB of 16.1 and CK-MB% of 2.1. Transthoracic echocardiogram revealed mild left ventricular hypertrophy, an ejection fraction of 50-55%, and some distal apical hypokinesis.

The patient’s neurological status began to improve while in the coronary ICU. He had no subsequent chest pain, SOB or arrhythmias. Electrophysiology was consulted and maximization of beta blocker was recommended, with no ICD needed. The patient was subsequently transferred to the stepdown intensive care unit.

Outcome and Follow-up

By the end of a week, the patient had nearly complete recovery of neurological function. Serial EEGs revealed improvement of encephalopathy. A head CT was negative for acute intracranial abnormalities. Phenytoin was stopped as seizures were felt to be due to lidocaine administration. Ejection fraction was normal on follow-up echocardiogram. He was started on lisinopril and atorvastatin. The patient was discharged five days following his heart catheterization, with a plan for routine post-MI care.

At one-month follow-up the patient has been doing well. He has continued with routine care and has been walking twice daily for about a mile. He experienced one brief episode of chest pain since, and underwent EKG, troponin and CK-MB testing all of which were unremarkable. The chest pain never recurred. He was found to be slightly orthostatic and had his enalapril decreased to 2.5 mg from 5 mg.

Global CARE Membership

Cleveland Clinic Global CARE Program is ideal for avid travelers and their families.

Becoming a member of Cleveland Clinic's Global CARE (Critical Care Air Rescue and Evacuation) program provides peace of mind. When you enroll you can be assured that if you are ever hospitalized while traveling more than 150 miles from your home, you can still receive Cleveland Clinic care. No patient is too sick or too far for transport on our fixed-wing aircraft, and there are no preexisting condition restrictions. We provide transport from anywhere in the world to Cleveland Clinic or the destination of your choice.

If you are unable to fly commercially due to your medical condition, day or night, our team is prepared to assist you. One phone call brings the expertise of Cleveland Clinic physicians, nurse practitioners, critical care nurses and allied health professionals to you. While in the air, our specialty teams provide care while maintaining communication with other physicians on the ground at Cleveland Clinic.

Enroll now

Why choose Global CARE?»

There are many travel insurance and premium credit card plans out there, but the Global CARE program is different. Dedicated to providing the highest quality of care, our team of Cleveland Clinic healthcare professionals is aimed at offering critically ill patients safe and rapid transport to Cleveland Clinic or the destination of your choice. We can begin treatment before arriving at one of our facilities, thus providing the highest possible quality of care to you and your loved ones.

Global CARE also makes the process as easy as possible, unlike most travel insurance programs.

  • There are no deductibles or co-pays for your transportation
  • There are no claim forms to fill out if transport services are used
  • There are a number of travel benefits, such as emergency language translation and travel assistance for family members
  • With your Global CARE membership, you are covered all year round, inclusive of all of your travels
  • There are no pre-existing condition clauses that would prevent your transport in the event of an emergency, though there are some restrictions for organ transplant patients.

If you are a Global CARE member, and you are hospitalized and cannot travel by other commercial means, we will transport you to a Cleveland Clinic facility or the destination of your choice at no cost to you.

Need more info?

Call us at 866.442.5092 or email us at ccglobalcare@ccf.org.

Pricing/Program Details »

Program Benefits

The greatest benefit that Cleveland Clinic's Global CARE Program can give you is peace of mind. If you or your loved ones are traveling, you can be sure that your healthcare is in good hands.

If you are hospitalized more than 150 miles away from home, and you cannot travel home by commercial means, Cleveland Clinic will transport you to one of our facilities or the destination of your choice without any additional co-pays or deductibles. Your care will begin right away, and you will have the expertise of a Cleveland Clinic medical team while in transit.

Additional Features
  • Pre-trip intelligence to include worldwide health alerts, travel alerts, visa & passport requirements, and destination information: Members of Global CARE will have access to a web-based portal that will direct them to various travel intelligence resources. Members can also call during business hours for information.
  • Emergency language translation services: If members are injured in a non-English speaking country, our foreign language service translators will ensure that communication between the attending doctor and Cleveland Clinic staff is seamless and efficient.
  • Travel assistance for family members to join critically injured or ill patients: Our travel experts will reach out to any listed contacts and assist in any way possible in order to reunite them with their loved ones as quickly as possible during their time of need.
  • Toll-free access for evacuation and general program information: All numbers will be free of charge to members no matter where or what time of the day the call originates.
Annual Plans
Global CARE Plans

Individual membership: $400
Family membership: $600

Need more info?

Call us at 866.442.5092 or email us at ccglobalcare@ccf.org.

Frequently Asked Questions»

»How is Cleveland Clinic's Global CARE Program different from travel insurance?

With the Global CARE Program, there are no deductibles, no claims to file, no maximum dollar limits and no out-of-pocket expenses. Also, travel insurance normally covers just one trip, but our annual plan covers every trip you take, all year long, and you can utilize your membership up to twice per year.

Travel insurance provides transport to “the nearest appropriate facility” and that can be anywhere but back home where you want to be. Travel insurance also states that it is the insurance company’s choice if they deem your transport a “medical necessity.” That means you have no control over how, when, if and where you will get treated. A member of Cleveland Clinic's Global CARE Program can always decide if they want to be transported to Cleveland Clinic or the destination of their choice—no matter how far away it is.

Let’s say you live in Chicago and have a boating accident, heart problem or bad virus in the Caribbean. You may be taken to that “nearest appropriate facility” hospital in Puerto Rico and can be there for several weeks. With our program, you get the quality and expertise of Cleveland Clinic care the moment our airplane touches down at your location.

»What does “No Medical Necessity” mean?

It means that unlike travel insurance or premium credit card plans, members of the Global CARE Program are not subject to their insurance company’s decisions on if and when transport can occur. The hospitalized member or his /her family decides if the patient is better off at Cleveland Clinic. When the physician confirms that the hospitalized patient cannot travel by commercial means, a phone call is made to arrange for the air evacuation.

»My premium credit card covers air ambulance service, so why would I pay for the Global CARE Program?

First, read the fine print, and then do the math. Your card probably gets you to the “nearest appropriate facility,” and may even pay to fly someone to be with you, but you have no control over your medical care or destination. It will also cost a great deal of time and money for anyone to be at your side during your recovery. No premium card or travel insurance guarantees you the choice of getting on a medical flight home (or to any hospital), where you can enjoy the comfort and loving support of family and friends — not to mention your own doctors.

»Are there any hidden deductibles, fees or co-pays?

No. The only cost is the annual fee. With the Global CARE Program, there are no out-of-pocket expenses for your transport. Not a single claim form to fill out either. Also, unlike travel insurance, our annual plan covers every trip you take, all year long, and you can utilize our transport services in the event of a medical emergency up to twice per year.

»How ill or injured must I be to be eligible for transport?

You must be hospitalized, over 150 miles from your home, and unable to travel by commercial means (such as an airplane, cruise ship, or rental car).

»Does this affect my health insurance coverage?

No. No claims are submitted to your health insurer should you require air medical transport because, as a Global CARE program member, your transport from hospital bed to hospital bed is prepaid.

However, hospitalization and related medical expenses are subject to the terms, conditions and exclusions of your health plan.

»Do I have to be in perfect health to qualify for membership?

No. In fact, we do not need any information about your current or past health status on our membership application. However, individuals who are hospitalized at the time of enrollment are not eligible for transport services for that hospitalization. Some restrictions regarding organ transplants are also found in our Terms & Conditions..

»Will Cleveland Clinic transport the injured/sick person’s traveling companion as well?

If room allows, a traveling companion(s) and one small piece of luggage may accompany the patient. We will also help with travel arrangements for any traveling companions who cannot accompany the patient.

Contact Us»

For membership inquiries please call: 866.442.5092

Global CARE Memberships

P.O. Box 932096
Cleveland, OH 44193

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