EMS Policy Manual - Contra Costa Health Services

Contra Costa
Emergency Medical Services
9-1-1 ACTIVATION CRITERIA FOR NON-
EMERGENCY TRANSPORT PROVIDERS
POLICY #: 39
PAGE: 1 of 1
EFFECTIVE: 8/1/2012
REVIEWED: 7/23/2012
I. PURPOSE
Define the criteria for upgrade to advanced life support (ALS) for non-emergency transport providers.
II. DEFINITIONS
Unstable: A patient who has a life- or limb-threatening condition requiring immediate and definitive
care. An unstable patient may have respiratory distress, airway compromise, neurological changes
from baseline, signs of actual or impending shock or may meet criteria for transport directly to a trauma
center. (Refer to EMS Policy 20 for additional information regarding patients with valid DNR and\or
POLST orders.)
Non-emergency ambulance provider: An ambulance provider holding a valid Contra Costa nonemergency
ambulance permit.
9-1-1 ambulance provider: An ambulance provider holding a valid Contra Costa emergency
ambulance permit and/or contracting with the County to provide advanced life support ambulance
response to 9-1-1 requests.
Code 3: Responding to a location and/or transporting to a receiving facility, using red lights and sirens.
III. UNSTABLE PATIENTS
A. A patient, determined to be unstable and/or needing “Code 3” transportation to a hospital, shall
be transported by a 9-1-1 ambulance provider, whenever possible.
B. Non-emergency ambulance providers may transport an unstable patient to the
closest/appropriate facility, if they can do so safely and the time from arrival on scene to arrival
at the hospital is less than ten (10) minutes. In all other cases, the non-emergency ambulance
crew shall activate the 9-1-1 system and request an ALS response.
C. Any non-emergency ambulance provider transporting a patient that becomes unstable during
transport should divert to the closest/appropriate ED per the Patient Destination Determination
Policy (Policy #9).
Receiving facilities should receive notification as soon as possible of the need for diversion,
patient status and the ETA to that facility.
D. All transports by non-emergency ambulance providers of unstable patients, and/or transports
requiring “Code 3” transportation are considered an unusual occurrence.
For each such occurrence, an EMS Event Report must be completed and submitted to the
EMS Agency within twenty four (24) hours of the call.
IV. “ON-VIEWS”
In the event that a non-emergency ambulance provider arrives on the scene of a collision, illness or
injury by coincidence, the crew shall provide appropriate care and immediately activate the 9-1-1
system.