Transport SOG

[bigblue439]

OK

I was wondering if anyone has an SOG on what hospitals they can transport to or how far they are allowed to transport. Lately I have had several PT's want to go to hospitals that are more that 1 hour away from us when there are several hospitals that are closer. I have no issue transporting to a specialty hospital if they need to go for a particular reason. These have been calls that could be treated at a local facility. We currently have no SOG leaving us with very little sense of direction on what to do in these situations. In only one of them did I transport to where they wanted to go and that was on because the Medics insisted we transport to that hospital. So does anyone have an SOG or suggestions for anything?

 

[JPINFV]

Are you 911, IFT, or combined? Private or public? Paid or free labor?

 

[Jon]

Your service officers should have a SOG for this... and this is a job for them, and perhaps the local EMS office and a lawyer. If you don't fairly enforce the rule, you can get jammed up about it, too.

 

[bigblue439]

We are a volunteer 911. I am in charge of creating SOG's I am just looking to see if anyone ah example. We have serval diffrent opinions among us about what is right. Just want to see what is everyones opinions.

 

[medicdan]

Again, this is region specefic, so take my words with a grain of salt (as you should anything on the internet). You have a responsibility to provide for your patient and efficient and rapid transport to an appropriate medical facility. You also have a responsibility to cover your response area (based on being volunteer 911, I presume your service has limited response resources).

That means that while you need to provide transportation to the closest appropriate facility, you need to remain close enough to maintain coverage. This is where the regional specific element comes in, I have no idea where you are from, and where your closest hospitals are (as well as tertiary facilities).

In your protocols, you need to discuss transport to specialty facilities (as you mentioned), such as designated stroke centers, STEMI centers (with PCI/cath lab facilities), burn centers, and finally trauma centers (hopefully you have a Level I close by).

You also need to develop a plan for the transport of stable patients going to their hospital of choice. Do you have reliable private services in your area? If so, consider throwing them a bone on stable patients requesting far away hospitals. They respond to the call on a priority (or not, based on your assessment), and you transfer care when they arrive.

Who are your mutual aid providers? Do they have extra resources? What are their abilities to cover for you in a timely manner? BostonEMS, in response to requests for their trucks to go all over the city (out of response areas) placed a policy creating for each truck a standard receiving facility (most often a L1). If a patient requests a different hospital, and is stable, they can call dispatch, and either ask for permission to go elsewhere, or call a private service. This angered a lot of patients, who ended up going to the closest hospital, but the trucks need to maintain city coverage.

Hope this helps (apologies for the ranting),

Dan

 

[bigblue439]

Dan thanks for your reply. Private ambulance is pretty much out of the question. We have 2 hospitals both about 30 minutes away that handle strokes and cath/labs. These are also the two closest hospitals to us. Our Level 1 is about an 1 hour away and that is only if there is no traffic. Needless to say most of our trauma patients get flown. We also have one other hospital that is about 35 mintues away. As for our resources right now we are doing pretty good and we can pretty much get two amblulances staffed daytime is sometimes hard. And somtimes we even get all 3 out for major incidents. Our mutial aid is combination during the day and one is also all volunteer.

Please let me know what you think of this but the policy I was thinking of would say that we could transport to one of the 3 closest hospitals unless it is a phyc emergency then they go to SCIP which is about 35 minutes away. And a truama then they go of coures. The only other reason would be for someone who needs a specialty hospital such as childrens hopsital which would be about a 2 hour ride for us with lights.