Successful transfer of a critically ill Covid positive patient from POKHARA AIRPORT to TIA AIRPORT AND then to NORVIC HOSPITAL through NMMF. Scenario was completely different from what we were told. As per the discussion with doctor over there, we were told pt is 87 yrs old male with no comorbidity maintaining saturation with lowest  24% Venturi mask and slight high RR of 24 but when we receive the patient he was in 60% Venturi mask with saturation 78% , Pulse 155 bpm, RR 35-40 per minute. We were totally shocked seeing the pt status and thought it would be a challenging case to transfer. Pt may collapse on the way to Kathmandu so we made of backup mind of LMA and Ambu mask if in case pt gets collapse on air. We secured new IV LINE on right hand. Loaded with Inj Pantoprazole, Inj Ondem, Inj methylprednisolone and Inj Lasix. Pt was switched to high mask with 15 Ltr O2. Despite all these measures saturation was just 88 % with pulse 152bpm. Thought of intubating the pt in airport but later took the risk and shifted the pt to helicopter. We started to give O2 via Nasal cannula too as pt was still hypoxic . We were in doubt weather we will have enough O2 till we reach KTM or not if we use both cylinder with high flow so we adjusted the flow accordingly. After using O2 via both high mask and nasal cannula sats gradually increased but pulse was still 150 bpm. Despite this we  asked the captain to fly  with big dilemma about what will happen in air. Thank God no adverse events were noted in air and finally took a deep breath after handing over the pt to the Norvic Ambulance team. Sharing some glimpses of today's mission.