Choosing a Hospital in an Emergency

Where would you like to go today? If you're an emergency ambulance patient, it's a relevant question. Most people have a preference of hospital, either because of past experience, insurance policy requirements, or physician affiliation. Most of the time, the staff of Tri-Community South EMS is happy to comply with a patient's request for transport to a particular hospital. Tri-Community South will transport patients to any facility of the patient's choice, within Allegheny or Washington counties, as long as:

1. The facility is approved by the Department of Health to receive ambulance patients,
2. The facility is open to receive ambulance patients, and
3. The choice will not endanger the welfare of the patient

What does this mean? Here are the explanations:

The facility is approved by the Department of Health to receive ambulance patients:

The Pennsylvania Department of Health allows ambulances to transport emergency patients only to a hospital emergency department, or to a care unit within an inpatient hospital. Ambulances may not transport emergency patients to a doctor's office or clinic.

The facility is open to receive ambulance patients:

Hospitals may temporarily close to emergency ambulance patients, according to a policy established by the Emergency Medical Service Institute on December 12, 2000:

A hospital may declare "Condition Yellow", which means that the hospital's emergency department is unusually busy, and that patients may experience significant delays in receiving treatment. If you are an emergency patient and choose to be transported to a hospital which has declared Condition Yellow, the ambulance crew will inform you that the condition exists, and will ask you if you have another choice of hospital. You have the option to choose another hospital, or to go your original hospital of choice, with the understanding that your care may be delayed, possibly by several hours, unless you are suffering from a life-threatening illness or injury.

A hospital may declare "Condition Red", which means that the hospital's emergency department is overwhelmed to the extent that they cannot safely treat additional patients. If you are an emergency patient and choose to be transported to a hospital which has declared Condition Red, the ambulance crew will inform you that the hospital is not accepting emergency patients, and will ask you to choose another hospital. Ambulances are forbidden to transport patients to a hospital that is under Condition Red unless the patient is suffering from a life-threatening illness or injury.

Specialty hospitals, such as Burn or Trauma centers will continue to accept patients with those conditions, even when the rest of the emergency department has declared Condition Yellow or Red.

A hospital may declare "Condition Black", which means that the entire facility is unsafe. This condition is reserved for extreme situations where the emergency department has been quarantined or evacuated. No patients may be transported to a facility which has declared Condition Black.

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The choice will not endanger the welfare of the patient:

A particular medical condition may warrant transport to a specialty care facility, other than the facility of the patient's choice. Severe traumatic injuries, for example, need the services of a Trauma Center. Critical burn injuries need to be treated at a Burn Center. If you have an illness or injury that merits the care of a specialty center such as these, and you choose to be transported to another facility, then the ambulance crew will advise you of the possible consequences of that choice, and they will require that you sign a release to indicate that you accept responsibility for these consequences.

If you have a life-threatening illness or injury that is beyond the capabilities of the ambulance crew to stabilize, the ambulance will transport you to the closest hospital, regardless of your choice, for immediate care and stabilization of the life-threatening condition. Once the condition has been stabilized, you may then be transferred to the facility of your choice.

When severe weather or road conditions physically prevent safe transport of a patient to the preferred hospital, the ambulance will transport to the closest hospital that can be reached. When conditions permit safe transport, the patient can then be transferred.

In all the above cases, the ambulance crew will consult with their Medical Command physician for medical direction. The patient's preferences are always given the highest possible consideration.

Conclusion: Usually, a patient's preference for a hospital will be honored by ambulance crews. When there are exceptions, they are because of medical policies established in the best interest of the patient's safety and convenience.

If you have any questions regarding ambulance transportation or Emergency Medical Services, call Tri-Community South EMS at 412-831-3710, Monday through Friday, 8:30am to 4:30pm.

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