Local EMS Agency Ambulance Diversion Policies — Riverside
- General Policy (BLS/ALS) Policy: 5310
- The purpose of this policy is to define when it is appropriate for Riverside County receiving hospitals to go on ambulance diversion.
- Hospitals shall make every attempt to prevent diversion of ambulances. However, in certain circumstances patients may be diverted. PATIENTS WITH AIRWAY COMPROMISE SHALL NOT BE DIVERTED.
- ED Overload Definition
- The acceptance of another patient with a life-threatening illness or injury would severely compromise patient care and safety (volume and acuity of patients at the time are the determining factors) or
- An internal disaster, HAZMAT, or similar unusual internal situation has occurred.
- ED overload shall not preclude a Base Hospital from providing on-line medical control.
- Neither in-patient staffing nor census may enter into the decision to divert.
- The decision to divert is made as permitted by hospital policy. The following steps are then taken:
- The Charge Nurse updates the EMS Agency and all local ambulance dispatch centers when going on and off diversion.
- Internal notification steps are taken in accordance with the needs of each hospital.
- When the two closest hospitals to a patient are both on diversion, the ambulance will take the patient to the closest, most appropriate facility regardless of its diversion status.
- Trauma Center Diversion
- Trauma cases may be diverted if one or more of the following conditions exist:
- If the CT scanner is inoperable, isolated head injuries may be diverted.
- Surgery is at maximum capacity and another crew cannot be mobilized. The O.R. will keep the emergency department notified of status.
- Trauma diversion will occur utilizing the same hospital specific internal authorization channels as specified above.
- If the closest trauma center is on diversion, the patient should be transported to an alternate trauma center within 45 minutes from the initial scene.
- In cases where an alternate trauma center is greater than 45 minutes from the initial scene, the patient shall be transported to the closest most appropriate facility.
- Diversion Evaluation
- The EMS Agency will provide regular reports to each Emergency Department Manager of the diversion data for that hospital that will include: dates, times on and off diversion, reasons listed for the diversion, initials and any comments or special circumstances.
- A report will be sent to the PCAC and EDDAC, for the purpose of evaluating opportunities for continuous quality improvement.
- Diversion records shall become part of the Continuous Quality Improvement process within each hospital and the EMS Agency.