The PHR team will initially rely on the information and assessment provided by the tasking agency. On arrival, a clearer history and assessment can be expected. The recent psychiatric history is of great importance and the team should ask about suicide attempts or ideation as well as observed violent or aggressive behaviour, especially towards healthcare workers (as in this case). Clinical assessment can be difficult, especially if the patient has been heavily sedated. The PHR team may be tempted not to disturb the sedated patient to avoid waking him and causing further agitation. In fact, the opposite applies. The team must assess the patient, gain intravenous access as required and inform the patient about the plan. It is better that the patient becomes combative and uncooperative prior to departure rather than during the transfer. Patient assessment should be carried out with the entire PHR team present (including the pilot). It is this entire team that the patient will be with for the next few hours and each member’s opinion and advice should be acknowledged.