am I covered by my facility when transporting? - page 2

Hi there. So, my hospital recently bought the hospital less than half a city block away. I am now overseeing many areas within both facilities. The roads between the hospitals are public roads and we have a contract with a local... Read More

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    My biggest concern would be the equipment you carry. Are you able to run a code with a single EMT to help you in the back? Paramedics do it all the time but their equipment is set up for it. A BLS rig wouldn't have ALS gear. Do you carry all the pressors you would need? I would think you would also need a set of protocols to cover you since an MD is not present if you need to start an amio drip for example. This is certainly possible, in fact, will happen sooner or later if you are doing cath lab transfers. IMHO you should have at least 2 ALS providers plus 1 BLS provider for what sounds like a critical care transport.

    Yes, you should be covered under their insurance even off the property since you are performing work.

    It sounds like you are operating without a clear job description/clear responsibilities. You should get yourself a job title and list of responsibilities (for your own liability protection).

    There should be a clear and written policy covering the role of nurses transporting in the back of an ambulance.

    Good luck.
    GrnTea likes this.

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    Your facility should have a policy on this. Mine does. As long as we follow our facility's P&Ps for our department/specialty we are covered.
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    You definitely need a set of protocols that are updated at least every two years and are signed off by a physician. These will provide a standard of care and act like orders while on transport. In addition you need a clearly defined medical control physician and a way to contact him immediately when the proverbial you know what hits the fan. It would be beneficial that you carry a transport bag with necessary equipment and medications you might need while on the road. This will augment what is on the rig but will also be familiar to you. It should be checked at least once every 24 hours and the zippers locked with breakaway plastic locks so you'll know immediately if something has been removed. Your facility's nursing scope of practice needs to be re-written to allow for the things you might have to do in an emergency. Your need for intubation skills depends on how far away you are. If it's only blocks than BVM is becoming the preferred method because of the high rate of intubation misadventures in the field. There are other adjuncts that are less prone to placement error and may be more appropriate in your situation. LMA's for example. In addition to all of that someone needs to review your state's laws regarding who can transport. For instance, in Ohio one of the people in the back has to be at least an EMT. It's stupid but it's the law. So all of the nurses had to get their EMT's since we transported with RT's. It sounds like your organization should really develop an honest to God transport system if this is going to be a frequent occurrence. They are asking for trouble if they think all it's going to be is throwing a patient in the back of a rig and driving from point A to point B.
    GrnTea likes this.
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    You should have a policy and procedure on the books that outline this. Just like anything else. We only ground transport now and we have to be checked off on the ambulance every year, usually the drivers do it. You have to know emergency shut offs, where everything is, who to work everything in the back, where the emergency kits etc are, how to use the in rig phone. We always had to do this for the aircraft too, but that was regulated by the FCC.

    You should also have your own flowsheets and documentation, and sets of standing orders if there is not a doc with you. And don't forget permits to transport if the patient is awake and alert. Anytime you take them off hospital grounds you should have a permit signed. We have to have parents sign them before we even leave the other hospital or even our own.

    Carrying your own insurance is a good thing too.
    GrnTea likes this.

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