Critically ill patients transferred between hospitals are often inadequately monitored in transit, with outcome adversely affected. In 22 such patients, we compared direct and palpated measurements of systolic pressure, oscilloscopic and aneroid manometric measurements of mean pressure, ECG and palpated measurements of heart-rate and clinical and oximetric assessments of oxygenation. On average palpated readings of systolic pressure under-read direct readings by 29% and palpated readings of heart-rate under-read ECG readings by 2%. The mean difference between oscilloscopic and manometric readings of mean pressure was zero. Oxygen saturation readings did not reach a level which allowed valid comparison. If direct measurement of heart-rate and blood pressure by battery-powered monitors is not feasible, palpation of heart-rate and manometric measurement of mean arterial pressure are acceptable alternatives during secondary transport of the critically ill.