Transport By Ambulance

The patient needed transportation by ambulance because

  • The patient was bed-confined (unable to get out of bed without assistance, ambulate, and sit in a wheelchair or chair)
  • The patient could not travel by other means without endangering the patient’s health because of the following medical conditions that existed at the time of transport:
    • Third-party assistance/attendant required to apply, administer, or regulate oxygen en route
    • The patient has an orthopedic device (backboard, halo, use of pins in traction, etc.) requiring special handling
    • The patient requires special handling or positioning to avoid further injury, and transport by wheelchair or gurney would be unsafe.
    • The patient is a fall risk due to: ____________________________
    • The risk of pt falling off of a wheelchair or stretcher while in motion due to: ___________________
    • The patient is on a psychiatric hold that requires restraints to ensure the safety of the patient and crew and reduce patient’s flight risk
    • The patient is confused, combative, lethargic, comatose, or incoherent
    • Isolation precautions are required for _______________
    • The patient is seizure-prone and requires trained monitoring
    • The patient has contractures of _____________
    • The patient has an unhealed fracture of the ______________
    • The patient requires advanced airway monitoring or suctioning or is ventilator dependent, possible intubation is needed
    • The patient is morbidly obese (BMI > 40, or has a BMI > 35 with the medical condition of _____________) with significant impairments to functionality requiring specialized equipment or additional personnel
    • There are wound precautions because the patient is unable to sit due to a Stage II or higher decubitus ulcer located on pt ____________
    • The patient has dementia/Alzheimer’s/ALOC/ AMS requiring cognitive monitoring
    • The patient requires medical monitoring due to _______________
    • The patient has severe pain in _________ of ___ / 10 upon movement
    • The patient requires continuously running intravenous fluids of _____________
    • The patient has paralysis (hemi, para, or quad)
    • The patient has other medical condition of _____________________________.