Psych Transports.

[fireflymedic]

In my area, we only do psych transports if there is a medical neccessity requiring them to be transported by ambulance (ie overdose, gunshot, etc). When they are transported that way, we have a state trooper with us (state usually responds with us, we don't have a city pd). In the event there is no medical reason, either state (usually) or the next county over S.O. transports. We used to transport, but after several violent psychs and the local nuthouse changing protocol to lock us in with the patient until a md sees them (which has been as long as four hours tying up a truck out of town), our protocols were changed allowing us only to transport for medical reasons and only with a police escort, (actually in the truck with us, not just following either). Tends to work well.

[nypamedic43]

The agency that I work for does psych transports all the time. As long as they are a voluntary admit for psych reasons and and have been cleared medically, we transport them in our car, which is basically a police cruiser, equipped with a cage and door locks and windows that are controlled from the front. We transport to Centre Hall, Clarion, Allentown, the State Hospital in Clark Summit as well as Buffalo and Rochester NY. All of these trips take 3 hours or more one way. We have one crew on for the night shift, so it splits us up and leaves the medic at the mercy of the powers that be, and hope that he can get an emt for the 911 calls that come in. The only time they will go by BLS ambulance is if they are an involuntary admit, and need to be closely monitored and have meds on board.

[hammerpcp]

My question is... Is there a law in place that makes non-emergent, stable, medically clear, voluntary psych patients have to go into the back of an ambulance? Or is it just the way that it gets done? I'm curious what each state or hospital uses for criteria... anyone know?

If they are on a "form one" (committed by a doctor under the mental health act, a.k.a. non-voluntary) and they are being transferred from, say the ER to a long term psychiatric facility they go by ambulance. Usually a PCP crew as per our P & P. A medically cleared voluntary psych pt would generally not be transferred to a long term facility, but if they were they could take a cab. I always do.

[Guest Beegers]

By me here in NJ, all psych transfers are done by BLS. Usually with a private BLS company that the hospital is contracted with. We also luck out here because most of the psych hospitals we deal with are not more than an hour away...I've gone to certain facilities so often that I get there quickly and they're like a second home where we're on first name basis with staff. The one facility we do emergencies for has a really cute tech there :twisted: .

If the patient is combative and such, we try to get an order from the doctor for either a sedative or restraints. One particular hospital, will only receive psych patients in 4pt hard leather restraints.

Paramedics are rarely called upon unless it's a medical emergency requiring one for transport to the ED. If it's a simple transfer and the patient is on a monitor for whatever reason, there are a couple companies in the area here that has nurses on staff for those kind of transports.

[cumcoemt84]

Here all of the psych transports are BLS. Unless they have some sort of drip going then there ALS

[ALERT Medic]

We have to transport psych pt's if they have done something to harm themselves...i.e. taken too many meds or tried and failed miserably to cut their wrists. If it's just a simple matter of someone who is depressed or hearing voices but has not done anything to harm themselves, the police will transport them to the local mental health facility. Only in cases that need medical clearance by a physician do we take them to the hospital...plus, the mental health facility here won't accept ambulance patients. I've had a couple of voluntary commitments coming from hospital ER's that we've had to transport but for the most part, we're dealing with the people who call us from home as a 911 call than the inter-facility transports.

[ALERT Medic]

Oh yeah, one more thing. It's easy to get frustrated with psych pt's...trust me I know. You have to remember that even though they are labeled by society as being crazy, that they have a legitament disease process that makes them that way. They can't always help the way they are.