Depends on what the facility is doing to take fall precautions. A matress on the floor doesn't need rails.
It also doesn't keep them from falling, either.
All right let me giva an example, of what Iam talking about. Say you have a STEMI pt. and your first in hospital is closer than the other hospital with a cath lab, I would take my pt. to the closedt, one I have an obligation to my community to get back in service right away, and two the pt. is going to recieve way more advanced care than i can give them as far as treatment and continuous Dx specific care, and third depending on the time of day with traffic and all they would benifit from all the specific medications involving the STEMI Dx than waisting time in the back of the ambulance fighting traffic. The er is going to get them to the cath lab anyways maybe by CCT transport or some other means, so thats my example. However where I work most places do have a cath lab so this is kinda of a far streched example, except for the traffic part sometime it's almost impossible just to get down the street in our first in.
The Cath lab is designed to handle that exact circumstance. The local Bandaid General isn't. I don't know what your drugs/protocols look like, and I'm sure I'll catch flak for this, but... There isn't much that ER is going to do that you can't do with the drugs provided and your ACLS protocols.
Why not contact Med Control? "Hey Doc, I got a STEMI, do I bring them to you and bypass Bandaid General? Yes? Okay, thanks." And then you're covered. Oh, and you're 30 minutes out? No problem. Because now that the Doc knows you're coming, he'll contact the Cath team, who probably take 20-30 minutes to get in to the facility. So now your Door-to-Cath time will probably be at a bare minimum. Time is heart muscle, and by calling ahead and going to the correct facility, you probably just saved this guy a LOT of trouble.
But no.. You -NEED- to go back in service! Oh my! The city will FALL APART if you drive an extra few miles to the proper facility! So instead, take them to Bandaid General, who will be forced (thank you, EMTALA) to do an assessment. So they'll do an ECG, a nursing assessment, a physicians assessment... In order to not look lazy, they'll have to do a rush on bloods and look at the results. Then probably hang a few bags and meds, just to feel like they can do SOMETHING. Then they have to call a CCT rig, that will take time to get there. And then call a report to the other facility. And maybe in a couple hours, the guy will finally arrive at the correct facility to get his Cath, which has meant much more heart muscle damage, and he forever gets winded going up the 5 steps to his front door. But hey, I'm sure he understands, right? You had to get back in service.
