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Transportation of patients between facilities

Posted Apr 02 2010 12:00am

What is the difference between transporting a patient in an ambulance or and private company, like AmbuTrans ?

The difference is in the quality of care provided by those transporting. In the case of a private ambulance services, they do not maintain the standards of care that a true ambulance provides.
Items such as proper restraints (suitable for a child, for example), hospital-standard clean linens, gloves, and highly qualified paramedics who can contain an emergency medical situation.

Now, in the case of a private company, like Ambutrans, personnel have 40 hours Emergency First Responder training, and  Level 'C' CPR and first aid

Who decides to choose a patient transfer vehicle over an ambulance, with paramedics?

Transporting Critically Ill Patients , explaines the parameters by which one assesses a means of transport for the very ill. One would think that even the moderately ill would require particular standards of care.
In addition, they are cheaper, because they do not possess the equipment necessessary, or the training of a paramedic. Patients, and their vulnerable families, are susceptible to the whims of such a means of transport. As an advocate, a family member needs to know that they will not monitor a patient, nor be able to provide emergency care.

Real stories about real emergencies

The sad story about the child who fell ill being transported between facilities is a perfect example. The mother would have know to raise a fuss if she had known that the child was NOT in the hands of expert emergency medical care, something we are used to in Ontario. All taxpayers are screaming for tax cuts, and we need to be prepared for situations like this one. This is a way to cut health care costs, but at what expense?

Real stories by real employees

 Not only does her documentary include information by those who were victims of this type of service, she talked to a former employee. Christopher Day, a brave whistleblower who stood his ground, says,
In fact that's the reason why I left AmbuTrans.  It was a situation just like that where we were forced to transport patients on a thirty-five degree Celsius day in a truck with no air conditioning in the back.  Patients and nurses who were transporting complained vehemently about the heat

He refused calls he felt were unsafe, a child with a full-leg cast, and a frail, aging patient with respiratory issues, cannot be transported in a vehicle without a/c.

The other issues include lack of education and/or preparation for employees around the issue of Superbugs (hospital acquired infections like MRSA and C. Difficile). This worker identified in the study told Tina that they did not have access to clean linens, gowns, masks and gloves. Their budget does not cover such, as is the case with more expensive ambulance paramedics. We know that even Pet Therapy dogs, as well as linens, can spread MRSAs.

Ontario Ministry of Health Response

Tina Pittaway's documentary says that in 2002 the Ontario Ministry of Health hired IBI Group to look into the patient transfer business.  IBI's report warned about the risks to patients because of the lack of standards.  It documented the frustrations of hospitals and municipalities forced to use patient transfer.

My advice: 
Insist that you understand if your family is being transported in an ambulance or a patient transfer vehicle. If it is the latter, be prepared to call for help. Be an advocate for your family member, travel with them, call for a real ambulance if you think one is required. If you wanted a truck, hire a fast truck driver. But be aware and be vigilant.

Download a transcript of Risky Business, which Tina Pittaway produced for CBC Radio.
Risky Business Transcript.doc

Risky Business  - View as HTML

Christopher Day: The child that I was requested to transport had a cast on ... we were forced to transport patients on a thirty-five degree Celsius day in ...
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