transporting two patients from different vehicles

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jemt

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Is it legal to transport two pt's in one ambulance from different vehicles in a motor vehicle accident?
 
jemt said:
Is it legal to transport two pt's in one ambulance from different vehicles in a motor vehicle accident?
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Why wouldn't it be?
 
I had a partner who flat out refused to do this and said it was illegal. I was never informed about it, so I thought I might be the ignorant one.
 
I can't answer as to the legalities of it, since I would think that would be area dependent. I can tell you, though, that I prefer not to do it (although there have been times when circumstances dictated that I had to do so).

I know not everyone gets mad when they are in an accident, but why put your patients in the uncomfortable situation of being in the same ambulance as the person they hit/were hit by. You just never know when someone is going to fly off the handle over something. That, and I know I wouldn't want to be giving my personal medical history and similar information to the crew with a total stranger present.

I have transported multiple patients from the same car at once, and am ok with that as long as none of them are serious/critical, thus requiring my undivided attention.
 
Pointless to put 2 units out of service for a call that one unit can easily handle.
 
Epi-do said:
I know not everyone gets mad when they are in an accident, but why put your patients in the uncomfortable situation of being in the same ambulance as the person they hit/were hit by. You just never know when someone is going to fly off the handle over something. That, and I know I wouldn't want to be giving my personal medical history and similar information to the crew with a total stranger present.
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I am by no means any sort of knowledge source when it comes to the application of HIPAA, but assuming one's agency does bill and all that, do we think that having two unrelated patients would be covered in the "incidental exposure" clause? I honestly have no idea here. Obviously state local law and regulations might preempt doing this anyway.
 
Exactly what Firefite said.

If it were illegal to transport occupants from different vehicles in the same ambulance, then you would have to dispatch an ambulance for each vehicle involved(with injuries). Ludicrous.
 
its not illegal i have infact done it before, last time i did both my patients were drivers and they got into an argument over whos fault it was during transport.
 
I dont make it a habit to transport multiple patients from different vehicles. For one, who wants their medical history exposed and discussed in the immediate presence of a stranger (other vehicle occupant). Also, what if some hostility occurs during transport from the different vehicle occupants?? It's not a good dynamic all the way around.

If its same vehicle where the people are related or know each other and are okay with it, than its cool.

Its not illegal, but don't think its best practice. With that said, do the best with the resources available at that time and hopefully you're explaining to the patients what is going to happen with transport before you do it.

TSSEMT - just seen your comment.. EXACTLY my point too!
 
I don't like to do it, but sometimes I have to.

I tell them in the kindest, joking manner possible that they are not allowed to talk about politics or this accident.

I've not ever had anyone get into an argument. Before we load them up, I tell each one separately and privately that this is what we have to do, resources are spread thin, and if they aren't ok with it, they can choose to wait on scene for the next ambulance, usually at least 20 minutes away.

They suck it up. Adults being grownups and all...
 
I have a feeling abckidsmom could talk any one into anything.
 
Usually, many in EMS like to say something is "against the law" when often there isn't even a written policy to cover that scenario.

Conventional wisdom is that one should avoid putting occupants from separate vehicles, especially the drivers, in the same rig - in case they argue/fight over causation of the collision.

In the end, though, there are times where it is far more appropriate than waiting on an additional unit (and then taking them OOS for the run, too).

One issue I've heard from billing friends is that they've run into issues billing for multiple patients transported in the same rig - sometimes the insurance companies refuse to pay. I know nothing more on that, but I've had BLS crews refuse to transport more than one drunk college kid because of that. (I don't really care, but it's silly to take additional crews OOS at 0200 because someone can't tolerate ETOH).

Whenever someone tells you something is illegal, ask them why. Ask them to cite the law or policy. Usually, they can't.
 
I had an engine captain want me to take a minor and an adult from the same accident but different cars. I refused he got upset but at the end of the day I don't want to be responsible for this minors information to be put on blast just because some captain doesn't want to wait any longer. I could however see it as being a HIPAA issue because most people don't want their info to be released to people who are not EMS or not hospital staff.
 
Look up "incidental exposure". It's not a HIPAA issue. Probably not the best situation but, things happen.

You can tell who's worked in a rural system before.
 
CBentz12 said:
I could however see it as being a HIPAA issue because most people don't want their info to be released to people who are not EMS or not hospital staff.
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I'll bite. How is it a HIPAA violation? Source please. Starting at the Center for MediCare/Medicade Services website on HIPAA would be a really really good start.
 
In my opinion, it would be best to use two different ambulances for transport. Patients are entitled to personal privacy. If it was me, if I am paying full price for the transport, you better dedicate that rig to me and only me. Our agency had a patient dispute their ambulance bill because the ambulance had two patients. Their argument was simple, why should I pay for the full cost of the transport if another patient was being transported as well. Shouldnt we both split the cost?... ever since, our agency does not allow two patients to transport together exception in the case of family members being transported.
 
mpena said:
In my opinion, it would be best to use two different ambulances for transport. Patients are entitled to personal privacy. If it was me, if I am paying full price for the transport, you better dedicate that rig to me and only me. Our agency had a patient dispute their ambulance bill because the ambulance had two patients. Their argument was simple, why should I pay for the full cost of the transport if another patient was being transported as well. Shouldnt we both split the cost?... ever since, our agency does not allow two patients to transport together exception in the case of family members being transported.
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So what about a MCI. Only 1 patient per ambulance? Even if they have minor injuries? So you have a 10 patient MCI with only minor injuries your really gonna take 10 units out of service?

If you are able to only transport one patient at a time then you must have a lot of units in your area.

We've never had an issue with transporting more then one patient and we do it often. Everyday we will have a unit transporting with 2 patients. The max I have transported is 5 at once. It only took 2 units out of service for a 9 patient MCI. We would get torn a new one by supervisors for only taking one.
 
Only when we dont have another unit available and not if either of them may require ALS.
 
I don't see a problem with it despite the argument/fight that may ensue in the ride. We don't let family ride unless they are a pedi and with teens its a toss up depending on the parents. We have 1 vehicle in service so we do not have the option to grab a second and in the event of a MCI we would tone out on call shift to grab the second rig but that could take anywhere from 10-30 minutes for them to arrive on scene.

Rural areas do have some disadvantages with this scenario but I haven't heard any stories where it caused a major problem.
 
mpena said:
In my opinion, it would be best to use two different ambulances for transport. Patients are entitled to personal privacy. If it was me, if I am paying full price for the transport, you better dedicate that rig to me and only me. Our agency had a patient dispute their ambulance bill because the ambulance had two patients. Their argument was simple, why should I pay for the full cost of the transport if another patient was being transported as well. Shouldnt we both split the cost?... ever since, our agency does not allow two patients to transport together exception in the case of family members being transported.
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For billing there are guidelines as to what you can charge. If both patients get equal care they get equal bills. As to mileage it can be divided between the two.

As a frontier medic we often have multiple patients that are from unrelated events. Sometimes during the long transports they become friends.
 
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