Interfacility transfers (IFT) are common events, and can range from prescheduled transports of stable patients to complex, multi-leg transfers of critically ill patients.  A common framing bias exists, where transfer events are viewed as lower acuity than prehospital events.  In many cases, patients are being transferred to receive a medically necessary intervention that is not provided at the sending facility.  In emergent cases, patients are undergoing transfer to receive a critical intervention at the receiving facility, and all efforts should be directly towards achieving that goal in a timely fashion.

• Careful planning is key to conducting a successful interfacility transfer, particularly in more complex patients
• Provide care within the scope of practice for the responsible paramedic crew
• In some cases, the sending facility will provide escorts if the patient requires interventions are beyond the scope of practice of the responding paramedic crew
• Ensure escorts (if present) are briefed and all equipment and personnel are safely restrained prior to transport
• Ensure all lines and tubes are secured prior to patient movement

• In patient’s undergoing air transport, package the patient on the appropriate lifting device (generally Ferno #9 stretcher with a mattress)
• Escalate any questions regarding air transport or airport meets to the Critical Care Paramedic Advisor via CliniCall
• Ensure all equipment and patient belongings are secured safely in accordance with current policy
• Family escorts may be considered on a case by case basis at the discretion of BCEHS
• Complete documentation is required for all interfacility transfers

In general, IFT destinations will be predetermined through consultation with the sending physician and the Patient Transfer Network (PTN).  Concerns related to appropriate destination should be escalated through CliniCall.

• A number of medications that fall outside paramedic scope may be either discontinued or have infusions completed prior to transfer
• This chart lists medications and devices approved by paramedic level according to the EMALB