Question: I've heard of crews being asked to transfer patients between facilities with indwelling tubes and lines that are not within their scope, and they don't have suitable escorts. I had a colleague asked to transport a patient with a chest tube, without an RN escort, to which they refused, but recently saw a crew transporting a patient with a nasal epistax in-situ. I know these have the potential to migrate and cause airway obstruction so didn't think we should move these without a hospital escort. Could the Base Hospital provide some direction so that it is clearer to paramedics as to what they should do in these cases?

The topic of inter-facility transfers is a complicated one. The topic has come up on Ask MAC previously, and the response has been copied here.

€¦this speaks to inter-facility transports and the scope of practice of paramedics vs. the responsibility of the sending physician to ensure that the patient is managed safely during transport. This is an enormously complex topic and not easily answered through the ASKMAC forum. We have attempted in the past to answer this and other similar questions. Ultimately, the sending physician is responsible for the welfare of the patient on transport and the role of appropriate medical escorts. However, when situations have arisen in the past, crucial conversations as to the various escorts that may be available to assist you (RT, RN, MD, Ornge) have led to enhanced patient safety on transport. Your supervisor and or the Base Hospital Physician may also be a useful resource if you are confronted with a transport where you feel the patient may benefit from an enhanced scope of practice. The Base Hospital will stand behind you in addressing safety concerns you may have when asked to transfer an unstable patient you feel requires additional medical escorts.

Miscellaneous,Policy/Procedures

Registered Nurse (RN)

No additional resources are available for this SWORBHP Tip.