Below are some of the other factors to consider for ambulance transfers to prevent the patient’s condition from worsening:

RESTRAINTS: It is crucial to determine if the patient may possess any threat of self-injury or injury to others, especially for psych patients. This factor can change the type of transport if the patient’s status indicates the need for mechanical or chemical restraints during transportation.

ISOLATION PRECAUTIONS: It is essential to determine if the patient may have anything contagious, shows symptoms of the patient’s disease, or has tested positive for a contagious illness. Patients needing isolation will need to be transported with the appropriate isolation precautions to prevent further spread to others. 

There are three kinds of transmission-based isolation precautions: contact, droplet, and airborne; the type used depends on the mode of transmission of a specific disease.  An example of a communicable disease spread by droplets and direct contact with the droplets is Covid-19; Covid-19 is transmitted through direct contact with respiratory droplets of an infected person (generated through sneezing or coughing). Individuals can also be infected by touching any surfaces contaminated with the virus and then touching their face (e.g., eyes, nose, and mouth).

MOBILITY STATUS:

• Ambulatory – Can safely sit, stand, and walk without any assistance.
• Semi-Ambulatory – Needs some assistance to sit, stand, or walk.
• Non-Ambulatory – Unable to walk but maybe mobile with the help of a wheelchair or other mobility device.
• Bedbound – Can only be safely transported via stretcher.

PATIENT’S ENVIRONMENT & ACCESSIBILITY: The surroundings or conditions in which a patient stays, lives, or operates. The patient’s environment plays a role when choosing the proper mode of transport and equipment. An example goes as follows: A non-ambulatory patient lives on a second floor and needs to get to their room but has stairs and narrow pathways as obstacles. This example requires a transfer using a stair chair or specialized equipment, plus a lift assistant-trained personnel to safely secure and move the patient to the stairs.

PATIENT’S WEIGHT: The patient’s weight will also determine how many lift assistants are needed and the type of specialized equipment to safely transfer a patient to or from a bed, wheelchair, or stretcher.

Every EMS company has different protocols. In general, unless there is a specialized device to assist in the transfer, a patient who weighs more than 250 pounds (113kg) is recommended to be moved with at least four individuals to help. For every 50 to 100 pounds (23-45kg) more than 300 pounds (136kg), an extra provider should be added to assist in the safe lifting and movement of the patient. For bariatric patients going into a fixed-wing air ambulance aircraft, please see our Fit Assessment for Bariatric Patients here: Fit-Assessment-for-Bariatric-Patients

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