Here in NYC, our protocols demand that "under no circumstances" we bring unstable patients anywhere but the nearest "911 receiving hospital". The only exceptions are for specialty care referrals or by telemetry physician order. Presently, the fire department (which regulates the 911 EMS system), is taking steps to enforce protocol issues with hospital selection.
Recognized Specialty Care Centers:
- Trauma Center
- Burn Center (Trauma takes precedence)
- Hyperbaric Center
- Replantation Center
- Spinal Cord Injury Center
- Venomous Bite Center
Most recently (Aug. 2006), Stroke Center is now recognized.
My bass ackwards city (and state) DOES NOT recognize cardiac center! If I have a patient having an acute MI, I am required to bring that patient to the nearest emergency room even if that hospital does not have a cardiac cath lab. Because I have a close working relationship with one particular cath lab (from several jobs, past and present), I know how important it is for an AMI pt to be on the cath table ASAP.
I've been able to manipulate the system sometimes in the past, but now I am just going to have to call telemetry for every MI unless they shut me up or change the rule.
Does your region recognize cardiac centers?
Recognized Specialty Care Centers:
- Trauma Center
- Burn Center (Trauma takes precedence)
- Hyperbaric Center
- Replantation Center
- Spinal Cord Injury Center
- Venomous Bite Center
Most recently (Aug. 2006), Stroke Center is now recognized.
My bass ackwards city (and state) DOES NOT recognize cardiac center! If I have a patient having an acute MI, I am required to bring that patient to the nearest emergency room even if that hospital does not have a cardiac cath lab. Because I have a close working relationship with one particular cath lab (from several jobs, past and present), I know how important it is for an AMI pt to be on the cath table ASAP.
I've been able to manipulate the system sometimes in the past, but now I am just going to have to call telemetry for every MI unless they shut me up or change the rule.
Does your region recognize cardiac centers?