Introduction: Little is known about ICU evacuation from the provider perspective. Specifically, there are few data on planning, training, communication and tools needed to effectively mobilize critically-ill patients that have very specialized ongoing care needs and may be equipment, medication, and oxygen dependent. Hurricane Sandy provided an opportunity to obtain this unique ICU provider input from multiple hospital perspectives. Methods: A cross-sectional survey was distributed to four NYC area hospitals via ACCP contact emails. Initial attempts were made to contact ICU medical directors from eight ICUs that evacuated due to Hurricane Sandy, but were unsuccessful in four cases due to access and responsiveness. Each hospital's ICU medical director distributed the survey to the RNs, RTs, and MDs that they identified to play direct roles in their evacuations. Respondents (n=75) answered a 23 item anonymous electronic survey, which included descriptive and categorical questions regarding job title, role during the hurricane, leadership position, and perception of preparedness. Additionally, they were asked open-ended questions about specific tools, supplies and equipment that were helpful or missing, ethical concerns, and key highlights of the response. Responses were coded for thematic penetrance by two independent reviewers. Results: Sixty eight of 75 initial respondents completed key survey questions and directly participated in the Sandy ICU evacuation. 35% of respondents were ICU nurses, 21% were respiratory therapists, 25% were physicians-in-training, and 13% were attending physicians. 34% of respondents had leadership roles during the evacuation. 63% were from medical ICUs or mixed ICUs, with 3% from neonatal or pediatrics ICUs. Although 61% said their ICU was involved at least somewhat with regional evacuation planning, 78% said they had not participated in an ICU evacuation drill in the past 2 years and 72% said they had no prior drill or real-life experience. In contrast, only 23% felt inadequately trained to perform a vertical evacuation despite the fact that 64% were directly involved with evacuation leadership, patient preparation, or actual patient movement. Patient prioritization was primarily determined during the disaster (47%), with tracking by disaster forms (21%) or typical transfer forms (28%). 37% reported sending medications for the <24 hours post transfer. 51% continued to provide patient care either in transport or at the receiving facility. The majority (83%) felt that they had good situational awareness and that the ICU MD (Director or Chief) should be identified as the ICU evacuation leader (65%). Respondents at each hospital mentioned the following primary successes: teamwork (57%), leadership (29%) and patient safety (16%). The primary barriers identified were: communication (43%), disaster knowledge/training/planning (10%) and walkie talkies/phones (7%). The most helpful tools were physical: flashlights (24%), transport sleds (21%), oxygen tanks or respiratory therapy supplies (19%) and ambulances (9%). An evacuation wish list included walkie talkies/phones (26%), lighting/electricity (18%), as well as flashlights (10%), portable ventilators and suction (16%). Conclusions: Evacuating ICU providers during Hurricane Sandy had little prior vertical evacuation experience, practice and non-standard processes for patient prioritization, tracking, medicine distribution, and ongoing care. However, only a minority of ICU providers admitted to feeling inadequately trained (23%) and this disconnect may reflect a lack of disaster preparedness awareness on the part of the ICU provider. Basic necessities, communication devices, lighting, flashlights, and portable ventilators were tools that could easily be targeted for preparation in the event of the next ICU evacuation. Our survey showed successes and challenges in the realms of social interaction with communication being a hindrance, and good teamwork ultimately contributing to evacuation success.