TRANSPORT PROCEDURES

TRANSPORT PROCEDURES

1. An ambulance must follow the transport priority ranking system outlined below, unless the patient is unstable or becomes unstable during transport:
   A. Patient's request
   B. Family request or guardian request, if patient is a minor or incompetent
   C. Patient's personal physician request
   D. If the facility of choice is of a distance that would remove the EMS vehicle from system availability for an extended time, an alternative choice will be allowed.
   E. No other individuals (i.e. police, fire, other physician) will be allowed to determine the destination of the patient without prior approval of the Medical Control physician.

2. If a patient is unstable, or should become unstable during transport, he/she should be transported to the nearest medical facility. For all transporting units, the Medical Control physician has the authority to divert an unstable patient to the closest appropriate facility.

3. Once an Advanced Life Support unit has been dispatched by protocol or request of the first responder, no basic ambulance is to initiate transport prior to the arrival of the ALS unit unless:
   A. The basic unit is going to intercept the ALS unit
   B. Estimated transport time is less than the estimated arrival time of ALS, or C. Transport is ordered by on-line medical control.

4. The following cases must be transported via ALS unit unless otherwise directed by on-line medical control.
   A. Life threatening or potentially life threatening emergencies.
   B. Whenever any medication, IV solution or any other invasive medical procedure is administered or anticipated.
   C. Minor with no guardian present.

5. Medical Control consultation is required for all patients prior to disposition/transport.

6. For patients who refuse transport or treatment (or any part thereof), SEE Against Medical Advice Release Protocol.

7. Transport will be made to the closest appropriate medical facility capable of handling the emergency unless on-line medical control concurs with the patient/family's request to transport elsewhere.

8. Transport requests for air ambulances may be made by field personnel as patient's condition and expediency dictates. Consideration should be given to the transport time to the nearest appropriate medical facility and potential for positive intervention by a physician on the scene prior to any request. Requests for an air ambulance are to be coordinated with Monroe County Central Dispatch. All air ambulance requests made prior to the arrival of an ALS unit are to be confirmed, once the ALS unit has assessed the patient and has contacted Medical Control with a confirmed E.T.A. (SEE Helicopter Policy)

9. An emergency patient who requires an ambulance response will not be transported to a free-standing clinic or free-standing surgical center without consent of the on-line Medical Control physician.

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