Ambulance Diversions

[JakeEMTP]

In the area where I work, we never have this problem as there is only 1 hospital here. The only time we are diverted is when the pt refuses to go to the local facility. I was reading this article and was wondering how many of my fellow EMT City dwellers came across this situation. If you are diverted, how frustrating is it? Does it affect pt care?

http://www.merginet.com/index.cfm?pg=vehic...;fn=diversionup

[Nate]

We make that choice ourself, but I'm not going to take a patient with a suspected head injury to an ER that doesn't have a working CT machine. I'm going to take another 5 to 10 minutes and go down to another one that has a working CT. We also transport based upon the patient's status and their current problem. There are two doctors at the local ER who usually ship everything out that is pedi related, so when they are on duty I will transport to Texas Children's ER if it is something that looks like it will take more then a quick fix. No need in keeping that child at the ER for two hours, then having to be transported to another Er a few hours later.

[medstudent30]

(Gets on her SOAPBOX) In the area that I work in you can bet you LAST DOLLAR that you have in your pocket that during the winter months (from around middle of October to middle of April) that one particular hospital diverts to the next closest hospital. Well, while en route to that hospital (which is about 12 miles away) THEY have closed their doors and are refusing to take patients. SOOOOOOOO the next hospital on down the line is about 20 - 25 miles away from the last facility. We have come to the conclusion that when we THINK that one of those hospitals are on diversion...........we have dispatch call to see if they are accepting patients. What I do not understand is WHY they close to EMS traffic...........but if you pull in to their facility in a private vehicle, you WILL be treated. If they are a trauma patient, we will of course call for Lifeflight or transport to a trauma facility. (gets off of her SOAPBOX) But honestly, I do have to say that it is ridiculous when your calling in to a facility with your radio report to hear from them that you need to divert. I mean how do you tell your patient that you have to go to another facility? It only makes them look bad, in my opinion, to hear that come across the radio. If they are going to close to anything but major illness/injury, then they should have a representative from the hospital call all the local EMS services to say "Hey we aren't taking anything minor, please advise your crews." Just my little piece of opinion. [/font:78321ecc7e]

[Nate]

The local ER's around here will call all of the major services they see; but it would take to long to call every single 911 and transfer service in Houston.

[ncmedic309]

It's actually quite common now that we are having to "redistribute" certain patients away from one of our main hospitals to some of the outlying sister hospitals. This usually applies to medical patients, peds and traumas are usually not affected by the redistribution procedures...

[Acosell]

http://www.ctv.ca/servlet/ArticleNews/stor...3953_22791993//

[JakeEMTP]

http://www.ctv.ca/servlet/ArticleNews/stor...3953_22791993//

Kudos to the Hon. Tony Clement! =D> At least the tories are good for something. :wink:

[mediccjh]

This applies for everyone in the US.

Everyone forget about EMTALA?!!

If you have a patient that wants to go to a hospital on divert, THE HOSPITAL CANNOT REFUSE THE PATIENT!!! It's Federal Law. I've pissed off my fair share of staff because of it, but I don't care. I take my patients where they want to go.

[strippel]

Staff at both our local ERs do not understand divert. For the longest time (despite our education efforts), they believed that if they were on divert, no ambulance patients could come in. As mediccjh knows, in PA, divert is a "courtesy" from ambulances to the hospitals.

I had one staff member at a local hospital ask me why we brought a patient there. She thought that dispatchers divided calls equally between our 4 county ERs. Boy, was she sadly mistaken. Her co-workers (many new, not from the area) ganged up on my partner and I. They could not believe that (gasp!) the patient actually made the choice.

My service, being "overseen" by three of the four county hospitals, we have to ask the patient their hospital choice. It that hospital is on divert, we must "educate them", make them a good health care consumer, and then offer them another choice. If the hospital they want is on divert, then so be it. We still get yelled at. Other services just take the patient to their hospital of choice, without offering up options.

One hospital sees over 60% of ER patients in the county. Some would be willing to go elsewhere, if given an option. When those 60% of patients are in beds, the 5% who really need to be at this particular hospital have delayed care.

[ncmedic309]

Actually, the hospitals in our area can put us on diversion regardless of the patient's personal preference...

We have 7 hospitals in the county, 4 are owned by one healthcare system and the other 3 are owned by another healthcare system. They simply divert the patient to one of their sister hospitals. The patient may not get their preference of location, but they can still remain in the same healthcare system and be seen at another facility...so legally they can go on diversion and refuse to accept a patient...