SECTION 310:641-13-20. Air Ambulance triage, transport and transfer protocols

(a)   Medical and trauma Department approved triage, transport, and transfer protocols or destination protocols shall adhere to the principle of delivering time sensitive medical and trauma patients to appropriate facilities as outlined by the regional advisory boards and Department approved protocols.

(b)   Specific triage, transport, and transfer protocols or destination protocols shall be developed by medicalcontrol for the region, area, or local service and submitted to the Department for approval.

(c)   Each patient or legal guardian of a patient has the right to refuse treatment or transportation from an air ambulance agency.

(d)   Each air ambulance agency shall ensure that the care of each patient is transferred appropriately to the receiving facility's licensed staff. The transfer of care will include verbal and written reports summarizing the assessment and treatment of the patient by the ambulance service.

(e)   All air ambulance agencies are required to participate in the regional and statewide systems, established through statute and administered by the Department, to ensure the patients are transported to the appropriate facility in a timely manner to receive appropriate care.

(f)   Each agency shall designate the receiving facilities that are within their reasonable service range.

(1)   An air agency may still transport to facilities outside of the reasonable service range on a case by case basis.

(2)   Repeated transports to facilities that are outside of the agency's reasonable range will require modifications to the designated receiving facility list maintained at the Department with the agency's approved protocols.

(g)   Triage, transport and transfer protocols approved by the Department shall include the following requirements:

(1)   medical and traumatic non-emergency transports shall be transported to the facility of the patient's choice if within reasonable service range;

(2)   emergency, non-injury related, non-life threatening transports shall be transported to the facility of the patient's choice if within reasonable service range;

(3)   emergency, injury-related transports shall adhere to the Oklahoma Triage, Transport, and Transfer Guidelines approved by the Oklahoma Trauma and Emergency Response Advisory Council and shall ensure that patients are delivered to the most appropriate classified hospital either within their region or contiguous regions;

(4)   severely injured patients as described in the Oklahoma Triage, Transport, and Transfer Guidelines shall be transported to a hospital classified at Level I or II for trauma and emergency operative services unless time and distance factors are detrimental to patient care. These patients shall be transported to the next highest level trauma and emergency operative service classified hospital, unless a Department approved regional plan has been developed; in which case the regional plan shall be followed;

(5)   stable patients at risk for severe injury or with minor-to-moderate injury as described in the Oklahoma Triage, Transport, and Transfer Guidelines shall be transported to the closest appropriate facility. These patients may be transported to the hospital of the patient's or patients legal representative's choice consistent with regional guidelines;

(6)   emergency, life threatening, non-injury transports shall be to the nearest facility that can provide evaluation and stabilization appropriate to the patient's condition;

(7)   transports or transfers from a pre-hospital setting that occur as a result of a physician order shall be transported to the facility ordered by the physician except when:

(A)   the patient or the patient's guardian chooses a different facility,

(B)   the patient condition changes, and going to a different facility is in the best interest of the patient,

(C)   the receiving facility's ability to receive that patient has changed,

(D)   the facility is not within a reasonable range of the agency,

(E)   the Trauma Referral Center requests a change in destination or presents reasonable options for a destination.

(h)   In counties with populations of 300,000 or more and their contiguous communities, injury related transports shall be directed and coordinated by the trauma transfer and referral center for the region.

(1)   All air ambulance services providing pre-hospital emergency services in these regions shall contact the trauma transfer and referral center at intervals determined by the Department to register the transport of an injured patient to a hospital.

(2)   All air ambulance services transporting injured patients on a pre-hospital basis from areas outside these regions to hospitals inside these regions shall contact the trauma transfer and referral center in a timely manner to advise the center of the patient transfer. The center shall maintain a record of the transfer for regional continuous quality improvement activities.

(3)   All air ambulance services transferring injured patients from hospitals outside these regions to hospitals inside these regions shall contact the trauma transfer and referral center in a timely manner to advise the center of the patient transfer. The center shall maintain a record of the transfer for regional continuous quality improvement activities.

(i)   Each air ambulance service shall ensure that the care of each patient is transferred appropriately to the receiving facility's licensed staff. The transfer of care will include verbal and written reports summarizing the assessment and treatment of the patient by the ambulance service.

(j)   All air ambulance services are required to participate in the regional and statewide systems, established through statute administered by the Department, to ensure patients are transported to the appropriate facility in a timely manner to receive appropriate care.

[Source: Added at 33 Ok Reg 1529, eff 9-11-16]