(a) Code 1 Patients. A Code 1 patient may be transported by any responsible individual who is competent themselves, and has a reliable means of transportation readily available. The preferred route of Code 1 transport is by a family member, but also acceptable are coworkers, friends or police personnel. The person providing Code 1 transport must themselves be competent (i.e. not under the influence of drugs or alcohol), and willing to assume all responsibilities for taking the patient directly to the hospital. If Code 1 transport cannot be arranged, the call may be upgraded to a Code 2 after consultation with medical control. Code 1 transport may be delayed (i.e. a minor abrasion or laceration), but the patient must agree to contact transportation as soon as possible and this must be cleared through medical control.
(b) Code 2 Patient. A Code 2 patient has been evaluated by paramedics on scene and has been determined to require ambulance transport, but whose condition does not represent a life or limb threatening emergency. Code-2 patients will receive medical evaluation and treatment and will be transported by Stow EMS to any approved hospital listed within the Stow EMS Protocols, according to the patient's preference. If a Code-2 patient requests to be transported by a private ambulance, Stow EMS will administer on-scene medical care, remain on scene until a private ambulance arrives, and shall transfer care to the private ambulance crew. A competent adult Code-2 patient may refuse Stow EMS treatment or transport against medical advice with proper documentation on an EMS Refusal Form. At least one Stow EMS paramedic and one EMT-A/Driver shall be in attendance for a Code-2 transport.
(c) Code 3 Patients. Code 3 patients are evaluated on scene and are determined by on- scene paramedics or by a medical control physician to need immediate ambulance transport because of life or limb threatening illness. If the patient's condition is critical or unstable, Stow EMS may opt to the closest (time) appropriate hospital regardless of family wish. In most circumstances, the patient may be transported by Stow EMS to any approved hospital listed within the Stow EMS Protocols, according to the family's/patient's preference. A competent adult Code-3 patient may refuse Stow EMS treatment and transport against medical advice with proper documentation on an EMS Refusal Form. If a Code-3 patient requests to be transported by a private ambulance, Stow EMS will administer on-scene medical care and will remain on scene until a private ambulance arrives and shall transfer care to the private ambulance crew. At least two Stow Fire Department paramedics and one EMT-A/Driver shall be in attendance for a Code-3 transport.
(d) Interhospital Transfers. Stow EMS should not be used for interhospital transfers. Any requests for such transfers should be referred to a private ambulance company of either the patient's or family choice.
There may be three exceptions to the above policy:
(1) A child is brought to the hospital with a parent when both need treatment (i.e. MVA). The child shall then be transported to Children's Hospital by Stow personnel (or vice versa).
(2) An in-hospital disaster requiring all available transport vehicles for evacuation is called, or a community disaster with similar consequences occurs.
(3) A patient in one hospital with a life-threatening condition needs immediate transport to another hospital where appropriate treatment is available.
(e) Nursing Facilities and Assisted Living Facilities. Stow EMS should not respond to routine transport calls from nursing or assisted living facilities. Such calls should be referred to the appropriate carrier. Should a medical emergency arise at a nursing or assisted living facility which the nursing staff feels warrants a 911 service request, Stow EMS shall respond to the call and evaluate as with any other emergency service request. If paramedics on the scene at a nursing or assisted living facility call determine that the patient's condition is non-emergent but the patient or staff still requests hospital transport, a private ambulance carrier may be called for transport.
(f) Simultaneous Response with Private Carriers. Stow EMS, on 911 calls, shall be in charge of evaluation at the scene even if a private carrier is simultaneously called. Any medical evaluation or transport decision shall be that of Stow paramedic in charge at the scene.
Likewise, at any incident involving multiple victims, Stow EMS personnel shall be in charge of the scene, and any treatment, transport, triage decisions shall be made by the medical officer in charge, in accordance with Stow fire standard operating procedures for mass casualty incidents or limited victim incidents. In incidents involving multiple victims in which transport vehicles from both private and public EMS units are available for transport, the Stow medical officer in charge will determine which unit will transport individual patients based on his assessment of severity and treatment needs.
Should a private carrier be called primarily to a scene involving public safety considerations (i.e. a fire, MVA, etc.), Stow fire dispatch must be notified and the appropriate medical units should be dispatched to the scene. Stow personnel shall control the scene and be responsible for medical decisions regarding transport and treatment.
This is a general statement of policy for Stow EMS transport. It shall not be deemed to create patient rights nor to create City duties, or obligations not otherwise expressly arising by statute. This policy shall not broaden or expand any patient rights or entitlements to service, nor establishing any particular or required level of care, treatment or service. In implementing the general policies, discretion must always be granted to on-scene personnel to do or not do such acts as they deem reasonable, based upon the facts and circumstances existent at the time and place of the call and the exigent or special conditions or circumstances presented. Nothing herein shall either limit that discretion, compel its exercise or punish its reasonable exercise, nor punish or create liability for any absence of the exercise of such discretion."
(Ord. 2017-43. Passed 4-13-17.)