A mobile intensive care module has been developed for aeromedical transport of the critical care patient. It incorporates monitoring, ventilator, oxygen and suction, and infusion pumps. The device clips to a lightweight stretcher, over the patient at hip to knee level. This system is compatible with nearly all patient transport vehicles and allows monitors to be run from vehicle power. An assessment of the system after more than 500 transports is that it represents a significant advance over systems used previously. The advantages and disadvantages of the system compared with unmounted or vehicle-mounted equipment are discussed.

Acute intermittent porphyria, porphyria variegata and hereditary coproporphyria are called "inducible" porphyrias because clinical and biochemical manifestations of the disease may be induced by certain drugs or clinical situations.! Much has been written on the problems involved in anaesthetising patients with inducible porphyrias.!•5 To our knowledge, no case has been reported of a patient with porphyria undergoing cardiopulmonary bypass. This is relevant as anaesthesia for cardiac surgery with cardiopulmonary bypass involves the use of many drugs, hypothermia and contact with plastics, and it is often prolonged. CASE HISTORY A 33-year-old male presented in June 1970 with abdominal pain of unknown origin. Investigation at that time led to a diagnosis of porphyria variegata. He presented in October 1970 with a rash on his face and hands, and again in November 1970 with abdominal pain and red urine. One brother had died of complications of porphyria.

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Defibrillation is a critical aspect of advanced life support, but the inherent risks in the procedure are increased when used during an aeromedical retrieval. The dangers of defibrillation in flight can be divided in to fire, electrical, avionic interference and physical carriage and packaging. A limited body of evidence exists concerning defibrillation in flight, in part, due to under-reporting. Changes in incident reporting, increased team based simulation training and awareness of the dangers of defibrillation should allow aeromedical teams to defibrillate patients safely and expediently.