# Paramedic choosing destination ER **URL:** \ **Category:** Factual Questions\ **Created:** [August 12, 2018, 5:59pm UTC](https://boards.straightdope.com/t/paramedic-choosing-destination-er/819483 "2018-08-12T17:59:13Z")\ **Posts on this page:** 4\ **Page:** 2
**Author:** ![Spiderman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/spiderman/32/230_2.png) [@Spiderman](https://boards.straightdope.com/u/Spiderman)\ **Post date:** [August 14, 2018, 5:11pm UTC](https://boards.straightdope.com/t/paramedic-choosing-destination-er/819483/21 "2018-08-14T17:11:08Z")
**Jeff Lichtman** got it right. EMS should transport to the closest appropriate facility. Bypassing a local hospital for a trauma center or stroke center is acceptable. A local ER crying “uncle” & asking EMS to divert elsewhere for a period of time is acceptable. Going where the patient wants to go, if it’s appreciably further is getting into a gray area. If anything happens to that patient enroute to the further ER, including a vehicle accident/incident, EMS personnel will need to be able to justify why they were going to the further location when things went south, otherwise they are in breach of their duty. > [@Chronos](#): > > There was a case a year or two back with a cop being abusive to hospital staff for following the hospital’s privacy policy. The cop was also on an ambulance crew, and threatened that he’d take only indigent patients to that hospital in the future, as retaliation. [Jeff Payne](https://www.cbsnews.com/news/detective-jeff-payne-fired-nurse-alex-wubbels-video/). > [@running\_coach](#): > > Is ER care no longer universal in policies? Probably a case of in-network vs. out-of-network & what percentage of the bill they’ll pay, & what type of discount off of ‘rack rate’ that they’ve already negotiated. ---
**Author:** ![outlierrn](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/outlierrn/32/3005_2.png) [@outlierrn](https://boards.straightdope.com/u/outlierrn)\ **Post date:** [August 14, 2018, 7:30pm UTC](https://boards.straightdope.com/t/paramedic-choosing-destination-er/819483/22 "2018-08-14T19:30:08Z")
In my county EMS protocols include diverting from the nearest receiving to the appropriate STEMI or trauma center. ---
**Author:** ![ZipperJJ](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/zipperjj/32/211_2.png) [@ZipperJJ](https://boards.straightdope.com/u/ZipperJJ)\ **Post date:** [August 15, 2018, 12:58am UTC](https://boards.straightdope.com/t/paramedic-choosing-destination-er/819483/23 "2018-08-15T00:58:00Z")
I was at a local ER this weekend and the nurse attending to my family member was complaining that squads bring too many patients to their ER “They will pass up several ERs to get here.” Her ER has a trauma center and is attached to a hospital with a cardiac unit, so they are well-equipped. They have 22 rooms in the ER! But she said there are a lot of patients that come in that don’t need the extensive care of their hospital, and could have been taken somewhere else. Why this happens (from an EMT’s perspective), I don’t know. Maybe they are hedging their bets and taking everyone directly to the top-of-the-line ER? FWIW my family member is a heart patient so the EMTs told us they were taking him to this further ER as opposed to the one much closer. They said they always take cardiac patients to that one. ---
**Author:** ![gotpasswords](https://avatars.discourse-cdn.com/v4/letter/g/c57346/32.png) [@gotpasswords](https://boards.straightdope.com/u/gotpasswords)\ **Post date:** [August 16, 2018, 5:07am UTC](https://boards.straightdope.com/t/paramedic-choosing-destination-er/819483/24 "2018-08-16T05:07:39Z")
> [@rat avatar](#): > > Note that this was in Benicia, California at they wanted to take me to Vallejo, where I knew through my girlfriend, who was an E-room nurse in Oakland that my wait time would have been for hours. > > She drove me to Walnut Creek and my follow care doctor agreed that I would have probably lost usability of my hand had I gone to Vallejo due to the long wait time. The Paramedics had hinted that if I could find someone to drive me that it would be better but had no choice. Guessing they were going to take you to Sutter? :eek: In your situation, I’d much rather be at John Muir as it’s a trauma center. Not that Sutter is a _bad_ hospital, but John Muir is IMHO a _better_ hospital. **Takeaway lesson for everyone** - learn and file away in the back of your head which hospital(s) near you is a trauma center, which one is the best for whatever specialty - cardiac care, pediatrics, etc. that’s important to you. [Previous page](https://boards.straightdope.com/t/paramedic-choosing-destination-er/819483.md?page=1)