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Interfacility
Transports
Clinical
Indications for Patient Transport
_
Burns _
Cardiac /
Pulmonary
_ Environmental
Emergencies _
High-Risk OB
_ Internal Medicine _
Limb Amputation /
Reattachment
_ Multiple Trauma
_ Neonatal
Emergencies
_ Organ Transplant /
Procurement _
Pediatric Emergencies
_ Spinal Cord
Injury
Information
Needs
_ Referring Hospital /
Unit _
Contact person & Phone number /
extension
_ Patient’s Name and Age
_ Reason for
Transport
_ Sending Physician
_ Receiving
Physician
_ Patient’s Location
_ Receiving Hospital /
Unit
_ Receiving Unit phone
number
_ Landing Zone
Information
_ Insurance Information
_ Fax Number
*
Medical Necessity and Medicare forms will be faxed, to be signed by
the physician, Assignment
of Benefits form to be signed by the patient, spouse,
parent, legal guardian or POA
Hospital Staff
Procedures
_ Notify hospital security of
pending transport
_ Give patient’s valuables to
family / Have family await the flight team’s
arrival
_ Copy patient chart, lab
results, X-ray’s, CT’s and MRI’s
_ Provide the flight team
with a copy of patient demographic sheet with insurance
information and signed faxed
paperwork
_ Provide patient report to
receiving hospital /
unit
_ Have a litter with O2
awaiting the flight team’s
arrival
_ Assist with transport to
aircraft if possible
* Family
members are not allowed to ride aboard the
aircraft
Sky
FlightCare Communications Center
_ Will provide updated
arrival time to hospital security and sending unit
_ If remote landing zone,
they will assist in making arrangements for ground
transport to and
from landing zone.
_ Also communicate with local
communications center.
Interfacility
Response area map 
199 Reeceville Road Coatesville, PA
19320
LOCATION:
N 40.00.60
W
075.47.07 |