Determining a Course of Action
Assess the situation. Before any actions are taken, you need to determine whether the patient's condition warrants transportation by emergency services or not. You should always ask the patient for their preference and take this into account providing that he/she is not unconscious, delirious, or in shock (in these cases, an ambulance should be called immediately). Here are a few common reasons for going to the hospital without an ambulance: The patient is going into labor. Labor generally takes a long time, and most deliveries are not life-threatening to the mother or baby. For these reasons, it is usually okay to transport a woman in labor to the hospital in a personal vehicle. The patient is bleeding severely. In this situation, the patient's life may be in immediate danger. Transportation to the emergency room without an ambulance should only be performed in this case if treatment can be obtained more quickly by driving the patient yourself. In either case, applying pressure to the wound or creating a tourniquet for the injured body part to stop or slow bleeding may be of immediate concern. The patient has been bitten by a venomous animal. Many animal venoms causes tissue and central nervous system damage. The more quickly an antivenin is administered, the more effective it will be. By transporting the victim yourself, you may be able to obtain treatment for the patient more quickly than by waiting for an ambulance. In the case of severe bleeding or a venomous animal bite, be sure you have someone call 911, alert the hospital and EMS that you are en route and the nature of the injury. Give the route you will be taking so that EMS and police can be there if you have to pull over or there are other complications.
Call emergency medical services. If you decide to transport the patient to the hospital yourself, call (or have someone else call) EMS to report the situation and have the operator connect you to the hospital to which you are headed (or relay the information for you). This will inform hospital staff of the patient's condition and will allow them to prepare for the patient's arrival to begin administering treatment as soon as possible. Be calm and collect yourself before you call. Be clear to the operator that you are transporting the patient yourself and that EMS are not needed at the site of the incident. You don't want to have an ambulance dispatched if it is not needed, as this is an unnecessary use of resources and could keep paramedics from helping someone else in need. Explain the situation to the operator. This person is likely someone with training and significant experience in emergency situations, and he or she might be able to provide critical information or guidance (such as first-aid techniques or fastest routes to the hospital) to you during patient transportation. Have as much information as possible available for hospital staff when the call is made. The more they know about the situation and the person in need of care, the more quickly and effectively treatment may be provided. If you relay through a third party, make sure he knows the route you will be taking; consider having him take a moment to write down the information you need to tell the operator.
Determine the best route to the hospital. If the situation is urgent but the patient's life is not immediately threatened, it may be worthwhile to take a minute or two before departing to figure out which route to the emergency room is quickest and free of congestion or obstructions. Make sure you're aware of the emergency room nearest to your location. If you are unfamiliar with the area, ask someone who knows, such as a bystander or neighbor. Ask also if that person would be willing to accompany you to help navigate effectively. Use digital maps that contain live updates on traffic conditions, accidents, and the like. A GPS-enabled smartphone with a navigation program is the easiest and fastest way to obtain this information and will automatically determine the fastest route for you. If possible, avoid traffic delay areas such as construction zones and streets with lots of stop lights. Keep in mind that freeways, although free of stop lights and with higher speed limits, can become gridlocked and offer relatively few outlets for reroutes.
Gather important items and information. In certain situations— when controversial medical procedures may be necessary, for example — having important items or information about the patient can speed things up: Patient identification, such as a driver's license or passport. Insurance information/card. Allergy information, as people occasionally keep on bracelets or in document form. Medication information (if the patient is taking any). Anything the patient may need on the drive, such as water, a blanket, or spare bandages. A living will. Consider bringing a family member, friend/bystander or current caregiver for the patient if you yourself cannot provide information on the situation. This person can also help tend the patient while you drive.
Choose a suitable vehicle. If you have options, select a vehicle for transportation that will be most comfortable and effective for transporting the patient. Your first priority should be reliability, as the last thing you want is to break down en route to the hospital. Here are a few other factors to consider: Larger vehicles like vans and SUVs (especially those with four or more doors) will allow loading and unloading of the patient more easily than more compact vehicles. Make sure the vehicle has sufficient fuel for the trip. A dependable, large car is not going to be of much use if it runs out of gas before you get to the emergency room. If necessary, consider making a brief stop for fuel. However, keep in mind that the longer you take to complete tasks like this, the better off the patient may be taking an ambulance. Consider the weather and/or road conditions. Don't choose a sports car if there is a foot of snow on the road just because it had its battery replaced most recently.
Ensuring Safety and Efficiency During Transportation
Get a third person to assist you. It may be useful to have a third person in the vehicle during transportation of the patient so that one person can tend to him or her while the other drives. If you do not have a third companion with you, ask a neighbor or bystander if they would be willing to accompany you on the drive. This step will be more important for some situations than others. For instance, someone losing lots of blood would benefit from a third person in the car to apply pressure to their wound, whereas a woman in labor may not need someone other than a driver. It is best to rely on someone you trust to fill this role if possible. This way, you can avoid any unpleasant surprises that might come with sharing a car ride with a stranger. For example, it turns out that that stranger is the driver's ex boyfriend of nine years ago. It would certainly make for an awkward car ride.
Ensure the driver concentrates on operating the vehicle. Avoiding distractions if at all possible will help guarantee that the vehicle's occupants are spared unnecessary risk. This advice applies to driving in any circumstance, but is especially pertinent to emergency patient transport because of the likely hectic nature of the situation. Using voice directions from a GPS-enabled smartphone will help the driver keep his eyes on the road. If you are driving the patient without assistance from a third person, calmly inform her that you need to focus on driving but that you will pull over if at any point she requires assistance. This will remind the patient that her safety is of primary importance and that the driver is there to help. If you are tending to the patient while another person drives, make sure the patient does not bump into or obstruct the view of the driver by keeping her in the back seat.
Obey traffic laws. Pay attention to signage, keep an eye out for traffic lights, utilize your turn signals, and avoid excessive speed and tail-gating. Traffic laws are put in place to maximize motorists' safety, so your best bet to get to the hospital safely is to comply with these. If the patient's condition deteriorates rapidly and the situation becomes more dire, you may find it necessary to speed or make turns where prohibited. However, reckless driving should be avoided if possible, as the risk it poses may outweigh the potential benefits of arriving at the hospital a minute sooner. Recklessly driving in a attempt to get there quicker may end in more than one person needing to be treated. Alerting the 911 operator to your route allows police to be near the area and restrict/control traffic flow if need be. You can use your vehicle's horn and lights to signal to other drivers that you are experiencing an emergency. Using your emergency flashers, flashing your high-beams, or honking repeatedly while attempting to get around other cars might alert other motorists that something is going on.
Park as close to the hospital entrance as possible. Do not waste time finding parking before you escort the patient into the emergency room reception area. Hospitals and emergency rooms have designated patient drop-off areas, usually located right at the building entrance. You can move the vehicle to an authorized parking spot once the patient has been received by hospital staff. If you need assistance getting the patient out of the car, you can run inside and quickly ask for help. It is highly likely that someone will be readily available to assist you. Leave your emergency flashers on when you exit the vehicle to inform others (such as parking enforcement officials) that you intend to move the vehicle shortly. In any case, it is highly unlikely that a vehicle parked in front of an emergency room would incur a citation.
Handling the Aftermath
Contact the patient's family members. Provide them with any known, relevant information about the situation. This will help the family how to proceed in making arrangements to visit the patient. Contacting the family will also enable them to attend to the patient's children or pets while she is in the hospital. Refrain from diagnosing the patient or providing a conjectural prognosis if you have not been informed by a medical professional of the patient's status. Any guesses about the circumstances surrounding the incident or the patient's wellbeing could prove to be false and might unnecessarily upset the family. If you are acting as a good Samaritan and do not personally know the patient, inform hospital staff that you don't know how to get in touch with the patient's family and that they are potentially unaware of the situation.
Offer information to hospital staff. In most cases, hospital staff will want to obtain information from you about the nature of the incident, the patient, and/or the details of the patient's transportation. Be sure to stick around long enough to provide this information if it will be of help to hospital staff. If you are close to the patient, you may also wish to stay at the hospital so you may be notified of her status and/or allowed to see him/her as soon as possible. In cases where illegal activity or foul play was a contributing factor to the patient's condition, you may be legally obligated to provide a statement of the incident to law enforcement officials. Laws vary by state, so be aware of your state's legislation and the possible existence of any "good Samaritan laws," which offer immunity from legal repercussions under certain circumstances. If the patient was wounded in a confrontation or other situation where another individual was at fault and you have contact information for other witnesses to the incident, furnish these details to hospital staff and/or law enforcement. Such information could be valuable in building support for any potential legal actions or insurance claims on the part of the patient.
Retrieve items for the patient. If the patient is required to stay in the hospital overnight for observation or extended treatment, you may wish to bring a change of clothes or other personal belongings/necessities to him/her such as his/her cell phone. This gesture could make her stay in the hospital much more comfortable. This step only applies to individuals who are family members or close friends of the patient. If the patient is conscious and you are allowed to see him/her, ask if he/she needs anything from home and whether it would be okay for you to retrieve those items for her. Always check with the patient's doctor before bringing anything into the hospital room. The patient's condition may make certain items unsafe for him/her to use or eat. Hospitals also tend to have high standards of cleanliness, and they might prefer that outside materials not be brought into certain parts of the facility.
Help the patient get home. Once the patient is discharged from the hospital, he/she will need transportation home. Unless a family member or friend has already made arrangements to do so, offer to drive the patient. After all, you brought him/her to the hospital in the first place; chances are good he'd/she'd be okay with you taking him/her home, too. Pull your car up to the hospital exit doors so the patient does not have a long way to go to get to the vehicle. The same guidelines apply to here as to the patient's previous drop-off. Depending on the patient's condition, he/she might need help getting to the vehicle and getting in and out of it. If you offer transportation, be prepared to also provide whatever assistance the patient requires in order to get home safely.
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