30 hours ago · The use of emergency medical services (EMS) inter-facility transport ensures that a patient receives the care they need in a time-efficient and safe manner. For clinicians, understanding the role EMS services play in tranpsort is essential for the proper use and referral.[2] ... Inter-hospital transfer of a patient may occur in emergent and non ... >> Go To The Portal
Guide for Interfacility Patient Transfer Providers involved in interfacility transfer of un- stable, critically ill, or injured patients should have the ability to continuously monitor and assess the patient’s condition and to intervene appropriately At a minimum, this would require skill and knowl- edge in the areas of:
nThe transferring hospital must send copies of all medical records related to the emergency medical condition If the physician on call refuses or fails to assist in the patient's care, the physician's name and address must be documented on the medical records provided to the receiving facility Guide for Interfacility Patient Transfer
EMS Inter-Facility Transport - StatPearls - NCBI Bookshelf Inter-facility transport is defined as the transport of patients between two healthcare facilities. The process is generally accomplished through ground transportation or air vehicles.
Emergency physicians, advance practice providers, and facility personnel should abide by applicable laws regarding patient transfer. All patients should be provided a medical screening examination (MSE) and stabilizing treatment within the capacity of the facility before transfer.
To ensure the best possible health outcomes, critically ill and injured children should be treated at the facilities most prepared to address their needs. Often, however, children are treated at local community emergency departments where pediatric specialty services are not available – i.e. pediatric burn care.
Therefore, healthcare facilities should have available written arrangements to formalize their procedures for transferring pediatric patients to specialized centers for optimal care. Such arrangements include both interfacility transfer agreements and interfacility transfer guidelines.
Generally, medical oversight during transport will reside with the medical director of the EMS transport agency , but this may vary depending on the jurisdiction. In some instances, the transport agency may not have a medical director and authority may come from a jurisdictional (e.g., county) EMS medical director.
Develop a communications plan that describes if and when the EMS transport agency, emergency management, law enforcement, public health, and the sending and receiving facilities will need to communicate with each other and how they will communicate (e.g., cell phones vs. radios that could be monitored by scanners).
Determine the appropriate level of PPE for each member of the transport team based on patient condition and symptoms, length of transport, operating environment, provider competencies, availability of supplies, and guidelines provided by CDC and supported by the EMS agency medical director. Involve stakeholders in these discussions, including EMS, public health, and clinical care providers. The determination should also consider a worker’s ability to wear certain types of PPE (e.g., medical clearance, and fit testing).
What this is for: Developing plans for personnel, including ground and air medical transport providers, managers of EMS agencies, EMS medical directors, local and state EMS systems, local and state health departments, healthcare facilities, and others involved in the interfacility (including intrastate or interstate), transport of persons under investigation ( PUIs) or patients with confirmed Ebola virus disease (Ebola).
Coordination among public health, healthcare, EMS, healthcare coalitions, law enforcement, and emergency management should occur during all phases of preparation and planning, and throughout the interfacility transport, as appropriate.
Consider the following when developing plans for ambulance preparation: patient symptoms, length of time required for the patient transport, whether the driver compartment is isolated from the patient, and whether a designated transport vehicle will be used. 29,30
Develop protocols for the management of the patient during transport. This should include any invasive procedures (e.g., suctioning , resuscitation) that should or should not be performed during transport in order to reduce the potential risk of exposure (see Section 8: Clinical Care during Transport ). Consider including a medical ethicist, infectious disease physicians with expertise in this area, and labor unions in these conversations. Determine if scope of practice of the transport providers is affected with interstate transports.
The examining physician at the transferring hospital will use his or her best judgment regarding the condition of the patient when determining the timing of transfer, mode of transportation, level of care provided during transfer, and the destination of the patient.
The mode of transportation used for transfers should be at the discretion of the treating provider and based on the individual clinical situation, available options, needed equipment and patient preference. Options for transport include but are not limited to ambulance, air-transport and private vehicle. Regardless of the method of transfer, intravenous access may remain in place if deemed appropriate by the referring provider.
The transferring facility is responsible for informing the patient or responsible party of the risks and the benefits of transfer and document these. Before transfer, patient consent should be obtained and documented whenever possible.
All patients should be provided a medical screening examination (MSE) and stabilizing treatment within the capacity of the facility before transfer. If a competent patient requests transfer before the completion of the MSE and stabilizing treatment, these services should be offered to the patient and informed refusal documented.
The optimal health and well-being of the patient should be the principal goal of patient transfer.
When transfer of patients is part of a regional plan to provide optimal care at a specialized medical facility, written transfer protocols and interfacility agreements should be in place. To ensure optimal patient care, non-hospital medical facilities should abide by transfer standards much the same as those outlined above.
Agreement to accept the patient in transfer should be obtained from a physician or responsible individual at the receiving hospital in advance of transfer. When a patient requires a higher level of care other than that provided or available at the transferring facility, a receiving facility with the capability and capacity to provide a higher level of care may not refuse any request for transfer.
Patient transfers are a physician to physician referral. It is the responsibility of the transferring facility to perform a screening examination, determine if transfer to another facility is in the patient’s best interest and initiate appropriate stabilization measures prior to transfer.
It is the transferring physician’s responsibility to know and understand the training and capabilities of the transporting EMS personnel. During transport, the transferring physician is responsible for patient care until arrival of the patient at the receiving facility.