OnLine Medical Direction - Dr. Swanson

Medical Direction

• Providers work under the Medical Director's medical direction not the Medical Director's license
• Medical Director accountable for ensuring qualified personnel providing patient care and evidence-based medical care protocols

Prehospital Provider Medicolegal Risks

• #1 MVC 
• #2 "bad refusals"
• Malpractice insurance covers medical control orders when answering radio calls in ED; variable as far as coverage for care provide "on the streets" beyond any applicable state Good Samaritan statutes

EMTALA with respect to EMS

• Triggered when EMS personnel (or patient) asks for ED "help"
• For hospital-based EMS systems triggered when EMS contact is made with the patient
• For interfacility transports, the referring physician is responsible for selection of the mode and crew to complete the patient transfer and is responsible until the patient arrives at the receiving facility

Air Medical Transport

Multiple factors related to air vs. ground transport: 

• Distance
• Out of hospital time
• Environmental conditions
• Availability of ground (or air) resources to complete the transport in a timely manner
• Crew configuration
• Specialized equipment needs
• NOT perceived risk of one form of transport vs. another.  DOES THE PATIENT NEED TO FLY?

Consider fixed-wing transport in appropriate long distances transports

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