Trauma.

[gotbeerz001]

First type - "Limited Trauma".

We call this "Code 2 Trauma". This is for the pt that met criteria for several possible reasons but my index of suspicion is low for significant injury. In these cases, the pt preferred hospital usually happens to also be the trauma center, anyways.

If they meet criteria based solely on mechanism with no pertinent findings, I can make base to bring in as a regular pt or go to pt choice (non-trauma center).

 

[NomadicMedic]

The patients wanted the community hospital, neither was injured beyond minor cuts and bumps, but the community hospital refused the patients, saying, "we don't take high mechanism trauma here. Take them to the trauma center."

I was going write a long diatribe about how I believe the the trauma triage tool is blah blah blah... But what's the use. The hospital where they should have gone wouldn't take them. End of story.

 

[Summit]

It would have been poetic if the pt AMA'd and then POV'd to the community hospital.

 

[Tigger]

The patients wanted the community hospital, neither was injured beyond minor cuts and bumps, but the community hospital refused the patients, saying, "we don't take high mechanism trauma here. Take them to the trauma center."

I was going write a long diatribe about how I believe the the trauma triage tool is blah blah blah... But what's the use. The hospital where they should have gone wouldn't take them. End of story.

What sort of punishment do you anticipate if you brought the patients to that hospital anyway?

It would have been poetic if the pt AMA'd and then POV'd to the community hospital.

It's happened...

 

[Brandon O]

You mean declined over the phone/radio? Or in person?

 

[NomadicMedic]

Via telephone.

 

[Brandon O]

Sounds like a preference, not a mandate.

 

[NomadicMedic]

Oh no. Most decidedly a mandate.

 

[Brandon O]

Not much they can do if you bring them there; that's EMTALA. No ED can actually refuse a patient.

 

[chaz90]

Not much they can do if you bring them there; that's EMTALA. No ED can actually refuse a patient.

Yeah...I've been met at a local band aid station with a doctor in the parking lot trying to shoo my ambulance away. I think this particular hospital has been fined for EMTALA violations in the past and just accepts them as an occasional cost of business.

 

[Tigger]

THis is what I run into. They say they will not take the patient, but we all know that's an idle threat. If the patient wants to go that facility, they are welcome to do so.

 

[NomadicMedic]

Well, I work for a hospital based service. If I took a patient there and they had told me no, it would most likely be the end of my employment.

 

[Tigger]

That would be a problem. We rely on our local hospital for too much revenue (they will transfer literally anything), so if they don't want the patient I will try very hard to convince the patient as such. But if the patient will only go to the local hospital and they need to go, I will still bring them in rather than just leaving them, as I am sure most of us would.

 

[NomadicMedic]

That would be a problem. We rely on our local hospital for too much revenue (they will transfer literally anything), so if they don't want the patient I will try very hard to convince the patient as such. But if the patient will only go to the local hospital and they need to go, I will still bring them in rather than just leaving them, as I am sure most of us would.

Both went to the level I, non emergent, traveled an hour and got a nice bill.

 

[DesertMedic66]

We have a hospital that will refuse transport of generally any trauma patients. The Doc/MICN will actually use the term refuse.

Our hospitals are now able to refuse patients based on our ambulance redirect protocol. Pretty much if we have too many units on bed delay at that hospital no other transports of stable patients will be allowed even if the patient requests transport to that facility. The patient is given the choice of transport to a different hospital or they have to sign out AMA.