stat transfers should they wait?

[Tigger]

I see where Medicdan is coming from here. A diagnosed STEMI in need of PCI at the critical access hospital is likely more deserving of a timely transfer than the Alpha level "sick person" or lift assist from home. I agree that there's no good solution, but many CCT transfers out of local community hospitals are far more time sensitive than the vast majority of 911 calls. It's hard to play the game of "probably" when EMDing a 911 call, but we all know the odds are in favor of the low triaged emergency response being extremely low acuity...This wouldn't be an easy concept to justify to residents of a district who are waiting for an ambulance though.

The actual volume of CCT transfers is very low. The issue is the hospital calling for a transfer for someone that needs a higher level of care but not urgently. We will send an available ambulance as soon as they call, so the expectation is they call and get an ambulance in 15 minutes. As said, a truly emergent transfer will be treated like a 911 call, but those are just not that common.

As for your last part, it has to be a serious consideration sadly. We have to raise our mill levy and hopefully a sales tax to maintain service and part of that is being responsive to the community's wants. If we have people waiting an hour for an ambulance, they will not support us. I'd like to say that we could use at as proof that we need more funding, but that is not what people want to hear. The community's wants to not dictate our operation procedures, but they have to be considered, as it is their service.

 

[Bullets]

I'm not sure I understand this. Although the hospital may be a higher level of care than you are able to provide during transfer, it's likely they have patients who require a level of care that is only available at a tertiary care center. Depending on the capabilities of your local hospital, this could include neurosurgery (for evolving SAH/SDH), PCI, pediatric specialties, etc. These cases may be, in fact, the calls easiest to EMD - the patients already have diagnoses, and in partnership with the sending staff, you can triage (what can wait 10 minutes for a response, what can wait 30, etc.). Assuming all hospital transfers are low priority seems to significantly compromise care for those patients, even in a region with limited EMS resources.

This is the situation in which HEMS is particularly useful. Im generally against the overuse of HEMS but these are the kind of things that they SHOULD be used for

 

[evantheEMT]

At my company we have to be at the facility for a STAT transfer within 8 minutes I believe. If it's a regular transfer it's like 20 minutes. The most unprofessional thing to do is lie on purpose.