• The onset of specialized centers, such as for cardiac and stroke patients, has increased the need for patient transport and, hence, transport protocols.ambulance interior - a image by Andrew Gentry from Fotolia.com
  
  Transport protocols describe the procedures that emergency medical service, or EMS, agencies use when transporting a trauma patient to a trauma center or emergency room. In the state of Florida, the Florida Department of Health is responsible for setting, enforcing and modifying protocol.
  
  

Geographical Boundaries

• EMS trauma agencies are licensed by the state of Florida to transport trauma patients to an approved trauma center or emergency room in the geographical area served by that EMS agency. If no approved trauma center or emergency room exists in that area, EMS can transport the patient to an approved trauma center outside the geographical area according to that trauma center's transportation protocol. An agency who intends to provide EMS services outside the area of licensure must obtain approval from the Florida Department of Health.
  
  

Uniform Agency Protocol

• The EMS agency is free to develop its own uniform transport protocol to be followed by all teams within that agency. This protocol should have the input of trauma centers and emergency rooms the agency serves, including trauma, emergency room and other physicians who have a direct link with emergency services transportation. Input also should include trauma center and emergency room administrators and other personnel who work with the trauma team.
  
  

Scoring System

• The EMS team rates each trauma patient with a scoring system. The patient is given a score for each anatomical region: head, face, chest, abdomen, extremities and external. EMS gives an overall score to assess patients with more than one injury. Separate assessments should exist for adult and pediatric patients. The assessment must be documented.
  
  

Minimum Criteria

• Florida Department of Health specifies the minimum criteria necessary to transport a patient to a trauma center or emergency room. These standards are to be posted within the EMS agency's protocol. In the case of air transport, all applicable Federal Aviation Administration regulations are in force.
  
  

Air Transportation

• The air transportation protocol pertains only to counties with a population of 1 million or more. When air ambulance service is available in the geographical area where the EMS agency is licensed, protocol does not allow the air transportation to travel outside that area unless all parties agree to an arrangement in writing. If air transportation is available and no agreement exists between parties, a patient with a life-threatening condition is transported to the most appropriate trauma center or emergency room.
  
  

Transportation Between Facilities

• When a trauma patient must be transferred from one medical facility to another, the discharging physician must agree, according to written EMS protocol, that the transferring EMS team possesses the medical skills, equipment and resources to provide the patient with necessary care. If the discharging physician does not agree that this is the case, the EMS agency may be required to send additional EMS personnel.
  
  

Department of Health

• The Florida Department of Health has the responsibility of making and enforcing all rules necessary to carry out these protocols, as well as modifying any requirement.