A few weeks ago Brian Behn (The Brian Behn) put out a blog on FOAMfratraising the question "When is a patient too sick to transport?"   This question sparked a TON of good conversation on social media with a very diverse population of opinions.     "As long as crew safety is addressed, then we should make every effort to get this pt to definitive care. Declining a transport due to "instability" when the pt is 100% going to die at the sending, does a huge disservice to your pt. "     "Given the picture painted, after all my checks and additional resuscitation efforts I'll make my decision. 3 hours by ground through the mountains and the patient is still peri arrest with zero likelihood of intact neurologic outcome? Nope. I don't put my ass on the line for futility."     Knowing Flight Paramedic, Vahe Enders (@calldaburd), spoke on this in the past (ECHO2017). I asked him to come on the show and continue this conversation.