I didn't pick an option because in my area there are really two totally different types of IFTs.
1. Transfers from facilities to regularly scheduled MD appointments. These are flat out stable patients that for whatever reason need to be in an ambulance. For example they have a recent hip fracture and need to lie flat, or are on 2lpm of O2, or have dementia and need supervision. ie Saint Mary's facility to Dr. Joe Schmoe, Optometrist.
In these cases it is "sit and watch" (or sit and chat depending on the pt) because we are simply the transport agency, we are not providing that patient any medical care really (aside from continuing O2 therapy which they are already on). If they are being transported by ambulance because of an injury that necessitates they lie flat, or lie down, I (or my partner) will re-assess the injury after moving the pt to make sure everything is still ok.
These calls are almost always taken by the EMT in my system.
2. Pts with newly changed conditions. These are the pts that spiked a fever, or had an LOC change, or fell, or developed a rash, or have abnormal vitals or any other number of things that the facility (or the doctor they contacted) feels needs to be evaluated at an ED. These pts get the full work up indicated for whatever symptoms they have.
Some may end up being taken by the paramedic, some by the EMT, but the paramedic always does the initial assessment. Often times if the pt has a "No interventions, no CPR" DNR the EMT takes their care because there is no difference between the care the EMT and the care the paramedic can provide at that point.
In my area if the pt has one of those, legally we are supposed to call for orders just to administer oxygen if the pt isn't on it already.
That all being said, we ALWAYS get a full set of paperwork on the pt. Meds, past history, allergies, and their most recent H&P, and if they were admitted to the facility for short term rehab, a hx of what the incident was that necessitated the rehab. Occasionally if the pts situation is serious and we need to leave and they don't have the paperwork ready we will forgo the H&P and tell the facility to fax it to the hospital. I think that has only happened once or twice to me though. Most facilities have someone call 911/our dispatch while someone else gets the paperwork ready because they know we want it ASAP.
Guardian - Where I work we are the only company. We do all the IFTs and 911 calls, and we use the same ambulances for both, meaning that even on an IFT a fully stocked ACLS capable ambulance will arrive. We aren't trying to "fool" anyone, we just don't have the resources (staff and spare ambulance wise) to have an IFT only non-stocked ambulance.
