When a relative falls seriously ill abroad, the first question families ask is usually "Can we fly them home?" The second is "How?" There are two main ways to move a patient by air: a commercial airline stretcher and a dedicated air ambulance (ICU jet). Both can be safe. The right one depends on how stable the patient is, how urgent the move is, and the budget. This guide explains the difference in plain language so you can have a clearer conversation with the treating doctor and with us.
What is a commercial stretcher flight?
On a commercial stretcher flight, the patient travels on a normal scheduled airline flight. The airline removes a block of seats, usually at the back of the cabin, and fits a flat stretcher with a privacy curtain. A doctor or flight nurse travels beside the patient for the whole journey, with oxygen, a monitor, medicines and emergency equipment. A family member can usually travel on the same flight.
Ground ambulances take the patient from the hospital bed to the aircraft and, at the other end, from the aircraft to the receiving hospital. Done properly, it is a bed-to-bed transfer.
It usually suits patients who are:
- Stable, but unable to sit upright for the length of the flight
- Recovering after surgery, a fracture, a stroke or a heart condition
- Breathing on their own, with or without a moderate amount of oxygen
- Not likely to need intensive care during the flight
Things to know: the airline has to approve the patient medically before it accepts the booking. The treating doctor fills in a medical information form (often called a MEDIF), and the airline's medical team reviews it. Stretcher places are limited on each flight, so a stretcher transfer usually needs a few days to arrange. The flight follows the airline's timetable and route, which may include a connection.
What is a dedicated air ambulance (ICU jet)?
A dedicated air ambulance is a private aircraft configured as a flying intensive care unit. It carries only the patient, the medical team and usually one family member. On board there is a ventilator, cardiac monitor and defibrillator, infusion pumps, suction, an oxygen supply sized for the whole flight with a reserve, and medicines for emergencies. The medical team is typically an intensive-care doctor and a flight nurse or paramedic.
Because the aircraft is chartered for the patient, it departs when the patient and paperwork are ready, not when a scheduled flight leaves. It can also land at airports that are closer to the receiving hospital.
It usually suits patients who are:
- On a ventilator, or likely to need breathing support during the flight
- Critically ill or unstable, for example after a major heart attack, severe stroke, head injury or sepsis
- Needing continuous infusions of strong medicines, or specialist equipment such as an incubator for a newborn
- Needing to move urgently, within hours rather than days
- Infectious, or otherwise not suitable for a shared airline cabin
Side-by-side comparison
- Best for: stretcher, stable patients who must lie flat. ICU jet, critical, ventilated or unstable patients.
- Medical team: stretcher, a doctor or flight nurse at the bedside. ICU jet, an ICU doctor plus a nurse or paramedic.
- Equipment: stretcher, oxygen, monitor and emergency kit. ICU jet, a full ICU set-up including a ventilator.
- Timing: stretcher, the airline's schedule, usually a few days to arrange. ICU jet, departs when the patient is ready, sometimes within hours.
- Airline approval: stretcher, needed (MEDIF). ICU jet, not needed.
- Family travel: stretcher, usually yes, on the same flight. ICU jet, usually one companion.
- Cost: stretcher, lower. ICU jet, higher.
Who decides which option is right?
The decision is a medical one, not a sales one. Before recommending anything, our doctor reviews the latest medical report and speaks directly with the treating doctor. Together they look at:
- Breathing: oxygen needs, and whether a ventilator is in use or may be needed
- Blood pressure and heart rhythm, and whether medicines are needed to support them
- Level of consciousness and any recent bleeding or surgery
- Flight length and the cabin altitude, which lowers the oxygen available to the patient
- Any infection risk to other passengers
If a patient is borderline, we will tell you honestly. Sometimes it is safer to wait a few more days in hospital and then fly by stretcher. Sometimes a jet is the only safe choice, even if a stretcher would cost less.
What about the cost?
A commercial stretcher is usually the more affordable option, because the patient shares a scheduled flight. A dedicated ICU jet costs more, because the whole aircraft, crew and medical team fly for one patient, often including an empty return leg. The final price for either depends on the route, the distance, the medical team needed and the ground ambulances at each end. We give families a written, all-inclusive quote before anything is booked, so there are no surprises.
Questions to ask any provider
- Is the quote bed to bed, including ground ambulances at both ends?
- Who will be on board, and what are their qualifications?
- Has your doctor spoken to the treating doctor?
- What happens if the patient's condition changes before the flight?
- Who handles the airline's medical approval and the hospital paperwork?
Talk to us before you decide
Send us the latest medical report and we will tell you which option is safe for your relative, and why. Our coordinators answer 24 hours a day.
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This article is general information and not medical advice. The right transfer method for any patient is decided by doctors after reviewing that patient's condition.