The Elephant in the Room (Clinical Image)

Dhari Alrashed, Eoin Fogarty



Packaging is an important part of transfer medicine. Appropriate packaging in a “layered” manner is widely accepted as a safer way to move patients who may have various cables or tubes attached.

In our practise we use modified ventilator airway tubing, approximately 0.5 metres in length with a slit down the longitudinal axis to contain these cables and/or tubes. This tubing has become colloquially known as “Elephant tubing”

This tubing is typically used to contain ECG wires and medication giving sets. The Oxygen saturation probe wires and one intravenous access is typically left out during the transfer process in order to be able to access same.



medicine; retrieval; critical care; prehospital

Full Text:



Driscoll P, Macartney I, Mackway-Jones K, Metcalfe E, Oakley P (Eds.). Chapter 2—STaR principles, in Safe Transfer and Retrieval - The Practical Approach, 2nd Edition. Advanced Life Support Group. 2002.

Ashton-Cleary D, Mackey K. Intensive Care Tutorial 319: Inter-hospital transfers. 2015. Available from Accessed on 18th March 2018.



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