RE: Transporting two patients

["Tom Waters" <tom@tomwaters.net>]

Ron-
I have in the past done so, at 2 different services.  Here is how ...

1] Consent and understanding from both patients and, if present, family
members. Oh, and usually we would advise the docs too.
2] There will be 2 care providers in the back.  Sure, in a 911
situation, a medic is expected to handle 2 patients to the hosptial, but
in prolonged, CCT, no medic should.
3] Yes, a defib per patient.
4] Billing is hinky, New Mexico medicaid (which pretty closely follows
Medicare) says that you split the base transport charge between the 2
patients, including the mileage.  Now, the fun part is when the patients
are of differing care levels.  Then, you can usually get away with each
patient receiving their appropriate base-rate, and just split the
mileage. (say you have a CCT med going on 1, but only ALS
meds/interventions on the other)
5] The confidentiality issues are pretty benign if the patients consent
and understand.  I have had at least one pair of men txptd together who
chatted (about their medical problems) the whole way, and had a ball!
6] Here is where things get fun, occasionally we would do this from a
community hospital, 1.5 hours away from a big city.  The two patients
were going to DIFFERENT hospitals in that big city, once we got there.
How do you not leave a patient alone in the rig?  One time, I am aware
of a crew having the family member who rode up front climb in back and
sit with their relative while the emt and medic took the 1st patient
into the facility.  Not recommended!  Usually we would just split the
crew, driver and 1 medic from the back went upstairs, and then came
back, drove to next hospital, and at the last destination, everyone went
upstairs.

We never had any problems, facilties usually understood, and were never
denied permission from a patient or family member.  They seemed to
understand that it was better for the service to not do these long, back
to back round trips, and they would be getting to the definative care a
lot quicker.

Ones you would never want to transport together:  Any impending birth
and another pt.  Any impending death, or who could need aggressive
rescus, sexual assault victims, children, custody cases, the victim and
the accused together, two drivers from same crash, one who caused it,
you get the idea.

Hope this info is useful.

(PS- We almost did this on a FW last month, 2 guys both from the same
industrial accident, stable.  I picked up 1 via RW, took to hospial,
other came in via ground (A-star is only 1 pt. Capable) once at
hospital, determined both needed the burn center.  The FW team was not
comfortable since they weren't familiar with the accident and patients
from the beginning, so we took 1 RW and 1 FW.  Good teamwork and
communications, NOT being afraid to say NO... )

Tom Waters
Medical Air Transport
New Mexico

-----Original Message-----
From: flightmed-admin@flightweb.com
[mailto:flightmed-admin@flightweb.com] On Behalf Of Ronald Bolen
Sent: Saturday, November 03, 2001 6:29 AM
To: flightmed@flightweb.com
Subject: Transporting two patients


Any ground programs currently transporting two patients? What is your
crew
configuration?
How do you handle confidentiality issues?
Do you carry two defibrilators?
How do you bill for these services versus billing for single patient
transports?
Any problems encountered with doubles?
All responses most welcome!

Ron Bolen
Duke Life Flight


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