How are you notified of an ER on diversion?

[ny10570 745]

How are you notified of an ER on diversion? If they're diverted due to volume its not such a big deal, but if the nearest stroke center's CT is down or maybe the whole ER is without power how do you know before you get there? I've got my little MDT that tells me everything, including when to go home. I did my short stint as a volley in westchester, and unless you happened to notice the fax from DES we wouldn't know what was going on. I'm assuming 60 would up date a unit if they were about to transport to a diverted ER, but what about the PD dispatched units. How reliable are they with that info?

[OoO 24]

We find out when we call in a patient notification. Could definitely use a better method.

[xfirefighter484x 234]

When we call out to DC911 that we are leaving the scene and en route to a hospital, DC911 will advise you of whether or not the hospital is on diversion.

Granted, that is if the hospital has notified the 911 center, but they seem to be pretty good at doing so. Either that, or word makes it back to the 911 center from other EMS agencies that have contacted the hospital, and are given the diversion order.

Edited June 21, 2007 by xfirefighter484x

[SWEMCC70 0]

I work at Southwest CMED (lower Fairfield County, Ct) and when a hospital calls in for a diversion (general, psych, trauma, CT scan or cardiac) to us we: tone an announcement over proper Medical Channels for that area including surrounding hospitals, call the local commercial services (AMR, Nelson, Access), call the neighboring CMED (South Central). When units responding to calls sign on with us we once again remind them of the diversion. The units can call in for medical direction for patient destination for any questions to the hospital through us. When the hospital goess off diversion, we repeat the same notifications.

[firemoose827 324]

I work at Southwest CMED (lower Fairfield County, Ct) and when a hospital calls in for a diversion (general, psych, trauma, CT scan or cardiac) to us we: tone an announcement over proper Medical Channels for that area including surrounding hospitals, call the local commercial services (AMR, Nelson, Access), call the neighboring CMED (South Central). When units responding to calls sign on with us we once again remind them of the diversion. The units can call in for medical direction for patient destination for any questions to the hospital through us. When the hospital goess off diversion, we repeat the same notifications.

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Could you have your people call my people?!!!! We need something like that at our dispatch, we get notified by the ER when we call in the report 5 minutes out. Kind of late to find out you need to do a 180 and head back the other way!!

[IzzyEng4 427]

I work at Southwest CMED (lower Fairfield County, Ct) and when a hospital calls in for a diversion (general, psych, trauma, CT scan or cardiac) to us we: tone an announcement over proper Medical Channels for that area including surrounding hospitals, call the local commercial services (AMR, Nelson, Access), call the neighboring CMED (South Central). When units responding to calls sign on with us we once again remind them of the diversion. The units can call in for medical direction for patient destination for any questions to the hospital through us. When the hospital goess off diversion, we repeat the same notifications.

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And to add, since I work up at C-MED New Haven (South Central) We get the diversion and also a confirmation from the receiving hospital they area accepting the diversion. Upon this, all first responder and EMS dispatch centers along with commercial ambulance services in our area are notified of the diversion. Any service we do direct dispatch to is announced over the air and if the have alpha pagers, the message is sent over them as well. We also announce the diversion on MED 10 to all units working in the field and also give them a friendly reminder as well when responding in the area of the hospital that is on diversion.

[RescueKujo 130]

Out here, while our medics do have a long list of standing orders, they still have "base stations" to contact for reports and some higher level orders (certain meds, physician direction, pronouncement in the field etc.) and that is when they are notified.

On a separate note, 9 ERs have closed since I started in 1989 in San Diego County EMS. Things are tougher, and at 1 point County EMS created a policy that if all the ERs in a regional area were on "bypass" they started accepting patients in rotation. Now, that has changed that the ER should accept the patient if their primary care is at that hospital. And while doctors and others don't believe it, EMTs are governed by the same policy.

[Remember585 815]

The agencies we dispatch thru 60 Control are notified when they call enroute to an ER if that ER is closed or on diversion.

At home, where we get dispatched by PD, we sometimes are told that the destination we're heading to is on diversion, however most of the time they don't say a thing and we get to the ER only to be bitched at.

[ny10570 745]

So pretty much unless you're centrally dispatched its hope for the best. Thats AWESOME. I brought this up because a family friend was recently taken to an ER after experiancing a CVA. Recieving ER's CT was down. Crew took her out of the ER and took her to another hospital where she was successfully treated with TPA and is looking at a full recovery with some PT. Her son wants to effect a change in the system and was all set to sue when it became clear that the only people who did anything wrong were the EMTs who abducted her from the first ER during triage.

This is frustrating because an MDT is a relatively innexpensive addition to an ambulance, especially in a system all ready to integrate. Centralized dispatch is even more cost effective, but has the imeasurable price of bruised egos. Sadly, had she died a little publicity could have gone a long way towards effecting change. Its hard to motivate people when an apparently healthy person goes up there and says I could be crippled or dead because of this, but I'm not.

[WAS967 97]

How are you notified of an ER on diversion?

Via bedpan. Usually flung at us by an angry nurse for coming in when "we shouldn't have". Love my job.

I love my job.

I love my job.

(I don't carry a gun for a reason).

[calhobs 110]

Phelps calls the Police Desk then they tone it out, and for the Med Center usually half way there because the radio signal wont go over the hill between us and valhalla

Edited June 23, 2007 by calhobs

[calhobs 110]

Via bedpan. Usually flung at us by an angry nurse for coming in when "we shouldn't have". Love my job.

I love my job.

I love my job.

(I don't carry a gun for a reason).

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Hope its not full

[vodoly 535]

In Englewood Cliffs NJ the PD gets info via MICOM (paramedic dispatch center) i believe they sent out teletype too

[Guest alsfirefighter]

Sometimes we get a phone call sometimes we do not.

While I am a big proponent of giving the courtesy of not going to a facility on diversion (a concept some BLS providers in my area cannot seem to grasp) if you do not notify me until I call in. Your getting the patient, unless it is something that will require definitive critical care.

I stress to many the importance of understanding that diverision is partially to take some of the load off of a receiving facility and more important on our end to ensure that the patient we have will be able to receive the proper care they need and deserve. Its not about you, its not about them. Its about your patient. Do the right thing. (Can some of you whom know who you are hear me?)

[Goose 188]

If i get notified of a diversion its usually via a fax from dispatch to the station, a request to land line dispatch, when i call in to work, or over the radio when i'm giving my initial report and then again when i roll the patient in.

Meh.

[Remember585 815]

Sometimes we get a phone call sometimes we do not.

While I am a big proponent of giving the courtesy of not going to a facility on diversion (a concept some BLS providers in my area cannot seem to grasp) (Can some of you whom know who you are hear me?)

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Hmmmm...........

[ems-buff 81]

The agencies we dispatch thru 60 Control are notified when they call enroute to an ER if that ER is closed or on diversion.

At home, where we get dispatched by PD, we sometimes are told that the destination we're heading to is on diversion, however most of the time they don't say a thing and we get to the ER only to be bitched at.

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Hospitals down here in the southern part of the county call the ambulance station directly I.E. SSMC, WPMC, WMC. if will are out on a job, they call our PD. who let's us kno via radio. it's a nice system, also some people check the county site for diversions or closures.

[ny10570 745]

The hospital calls all of the stations?? when did this start.

[Guest DADAY]

The thing that bothers me the most is how mad the ER staff gets, like diversion means that they are CLOSED. No it doesn't, like mentioned before it is a courtesy, and most times I give that to them.

[Guest]

In granville (western MASS) my department is dispatched from Northampton MA. So we get tones, then the dispatcher comes over "attention Granville units with a special announcement, Baystate Medical (noble, mercy, etc) will be on diversion until (states the time).

Northampton control cleared and standing by

[EJS1810 7]

In granville (western MASS) my department is dispatched from Northampton MA. So we get tones, then the dispatcher comes over "attention Granville units with a special announcement, Baystate Medical (noble, mercy, etc) will be on diversion until (states the time).

Northampton control cleared and standing by

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Thats fine until they go on diversion at 0330. I try to tell a crew that would normaly use the facility on diversion when they respond. If I don't get it then, I will get them when they sign enroute to the hospital. Then they will go there anyway

[Remember585 815]

Most hospitals in WC make calls to local dispatch and EMS centers. The only downfall to this is that each dispatch center does things differently. For example, our PD may get a call and/or a fax, but the D.O. who takes that info may be on the road when EMS gets a call and the covering D.O. may know nothing about it. This applies to a lot of things when you rely upon word of mouth / paper trails. A good CAD system can keep everyone on point with things going on that people tend to forget mentioning to oncoming shifts...

[NJMedic 96]

There are several ways of obtaining divert information in my little section of the Garden State. The State Office of EMS maintains what they call JEMSTAT. It is a computer database of all the acute care hospitals and it lists their status. It is updates every 30 seconds. Each hospital is provided a log in name and are required to maintain their status. Particpation in this progran is required in order to receive state funds. The web site is www.jemstat.org.

My dispatch center also maintains a hotline that will also tell you what hospitals are on divert, 732 418-8400

Of course no one screws with EMS while they are on divert. Oh sure some one losses their cool and gives us grief every once in a while but we have ways to "get even"

[Guest paramedico987]

I'm usually notified as I walk through the front door and someone snaps at me obnoxiously as though I made all of these people sick...

It's busy! Put on your big girl panties and DEAL WITH IT!

If you think you're busy take a little walk through Monti on a Friday night.