Booking Patient Transport

Transporting a Patient? 

Read below for information and downloadable documents on Booking Patient Transports. If you have any questions or concerns, visit the Healthcare Partner FAQ or the PTAC website.

Information for Booking a Patient Transports

Please click the subject below to read or download detailed instructions to help book your patient transport. 

Critical Care Land Ambulance Program

Medical Scope of Service Utilization Criteria

The following is a guideline to be used to determine if a patient meets the scope of service criteria for the Ornge Critical Care Land Ambulance Program.
 
All issues regarding the medical use of the service will be resolved by the Ornge Online Medical Control (Transport Medicine Physician).
 
  1. Patient requires the ongoing administration of medications and/or blood products during transport that is above and beyond the scope of practice of a Primary Care Paramedic.
  2. Patient requires the use of specialized equipment or monitoring devices during transport. Examples include, but may not be limited to:
    1. Ventilator
    2. External pacemaker
    3. Multi-channel infusion pump(s)
    4. Hemodynamic or invasive monitoring
    5. IABP
  3. Patient requires a level of care during transport that either:
    1. Exceeds that of general nursing care
    2. Beyond the scope of practice of a Primary Care Paramedic
  4. Patient is at high risk of deteriorating during transport and may require specialized medical intervention.
  5. There may be circumstances where a request for service does not meet the above criteria. These circumstances will be evaluated on a case by case basis and will be escalated to the Transport Medicine Physician for a final decision as required.
 
Call Log on to
Operations Control Centre
Please provide:
  • Your name
  • Hospital name and city
  • Contact staff and number
  • Patient name, age and weight (for air transport)
  • Reason for transfer
  • Medical history (including vitals & lab values
  • if applicable)
  • Drug infusions being administered
  • Equipment requirements
  • Receiving hospital contact information (name & person)
  •  OHIP number
https://www.hospitaltransfers.com/transfer
 
Selecting “Emergent” and “Land” will alert the Operations Control Centre that land transport is required.
 
Provincial Transfer Authorization Centre
to obtain your PTAC Medical Transfer # (MT#)
fax PTAC request from to:
 
1 866 301 5262
or call:
1 866 869 7822
 
 
Want more information?
A Communications Officer is available 24/7 in our Operations Control Centre to address any concerns you have by calling 1.800.387.4672.

Preparing a Patient for Medical Transport

The transport medicine environment is challenging. To carry out the transport safely, your patient may need interventions prior to transport that would not be performed if the patient remained in your hospital. To minimize the time the Ornge crew needs to prepare the patient for transport, please consider the following before the crew arrives:
 
Information – please have someone available to communicate pertinent details to the medical call taker, transport physician or crew and answer further questions as required. Physician to physician communication is often helpful and there is a transport medicine physician available 24/7.
 
  • Incident history and relevant past medical history
  • Medications and allergies
  • Treatment and response to treatment, equipment, ongoing infusions and therapies
  • Recent vital signs and pertinent physical findings
  • 12-lead ECG (when pertinent) results and significant lab values
  • Diagnostic imaging results – if on PACS or CD, please allow crew to view images
  • Resuscitation status: DNR or advanced directives
 
Please make copies of all documentation for the crew to bring to the receiving hospital.
 
Patient preparation for transport (*as appropriate)
 
  • Intravenous access (2 large bore peripheral IV’s if hypotensive, active/severe hemorrhage, severe trauma, sepsis or burns)
  • Foley*
  • Gastric tube*
  • Airway supported / secured* (e.g. GCS<=8)
  • Recent ABG if ventilated
  • Spinal immobilization*
  • Arterial line/central line*
  • Blood products*
  • Pregnant patients in active labour require a recent pelvic exam within the last hour prior to transport to assess likelihood of imminent delivery
  • Medications (prn or regular) administered prior to transport particularly if being transported by primary care paramedics who will not be able to administer this in flight e.g. antinauseant, analgesics as appropriate
  • Extremity fractures are splinted
 
On arrival, the Ornge transport team will:
 
  • Take history and do brief physical assessment
  • Review copies of patient's chart and other pertinent data
  • Contact the Transport Medicine Physician for medical direction as required
  • Ensure patient is prepared for the transport
    • cardiac, blood pressure, oxygen saturation monitoring
    • ensure all IV access is well secured and place pressure bags on intravenous fluid bags and use infusion pumps as necessary. Lines may need to be switched to the standardized air transport system
    • secure the airway for intubated patient by checking ETT placement (clinically and/or CXR) and ensure ETT taping is appropriately secured
    • stabilize patient on a transport ventilator for intubated/ventilated patients
    • perform other interventions as required
    • transfer patient to a stretcher and securely strap in place

Want more information?
A Communications Officer is available 24/7 in our Operations Control Centre to address any concerns you have by calling 1.800.387.4672.

Booking a Patient Transport

Transferring a patient with Ornge? Here is a checklist of essential information required to booking an Ornge patient transport. 

In an effort to provide high quality care to patients, please ensure you read and complete this checklist before booking a patient transport with Ornge.
 
Patient severity:
 
  • Emergent (life-threatening, unstable patient)
  • Urgent (non life-threatening, prompt transport required)
  • Scheduled (booked appointment/time sensitive, CT, MRI, clinic)
  • Routine (deferrable, non-urgent)
  
Patient information:
 
  • Name
  • Date of birth
  • Weight
  • Health card or band number (may also include WSIB or other identifier)
  • Escort if applicable (is this transport a treat and return?)                            
  • Sending and receiving facility, department, and contact information
  • Incident history/diagnosis and/or reason for transport
  • Diagnostics and treatment
  • Medical equipment required (ventilator, oxygen, IV pump(s), monitor, ECMO, IABP, etc.)
  • Lines and tubes (IVs, art line, central line(s), chest tube(s), NG/OG, JP drain, foley, etc.)
  • Infusions (sedation, inotropes, nitrates, anticoagulants, etc.)
  • Medications and dosages
  • Relevant past medical history
  • Allergies
  • Code status
  • Isolation concerns (contact, droplet, airborne)
 
Please make copies of all documentation for the crew to bring to the receiving hospital.


Want more information?
A Communications Officer is available 24/7 in our Operations Control Centre to address any concerns you have by calling 1.800.387.4672.

Paediatric Transport Utilization Guidelines

The following are guidelines for health care facilities when deciding if Ornge should be considered for medical transport (air or land). Each case will be individually evaluated and if required an Ornge Transport Medicine Physician/Paediatrician will be involved.
 
The child (age less than 18 years) should meet one of the following guidelines for medical transport:
 
  1. Child requires specialized paediatric expertise.
  2. Child requires the ongoing administration of intravenous medications and/or blood products during transport.
  3. Child requires the use of specialized equipment or monitor- ing devices during transport. Examples include, but are not limited to:
    1. Ventilator
    2. Multi-channel infusion pump(s)
    3. Hemodynamic or invasive monitoring
  4. Child is at high risk of deteriorating during transport and may require specialized medical intervention
 
There may be circumstances where a request for service does not meet the above guidelines. Ornge will assist health care professionals in determining the right level of care with the right type of vehicle (air or land).
 
Ornge does infant and paediatric transport.  For all infants < 28 days or < 5kgs- please continue to consider accessing the hospital based neonatal transport team for your region. Ornge works collaboratively to provide support to the neonatal transport teams for long distance transports.

Want more information?
A Communications Officer is available 24/7 in our Operations Control Centre to address any concerns you have by calling 1.800.387.4672.

Download PDF | Download Plain Text Document

Preparing a Paediatric Patient for Medical Transport

Please have someone available to communicate pertinent details to the Communications Officer, Transport Medicine Physician or Paramedic. Physician to Physician communication is often helpful and there is a Transport Medicine Physician available 24/7. Verify with Ornge whether or not a parent can accompany the child.
 
Please make copies of all documentation for the Ornge transport team and the receiving hospital:
 
  • Incident history and relevant past medical history.
  • Medications and allergies.
  • Treatment and response to treatment, equipment, ongoing infusions and therapies.
  • Recent vital signs and pertinent physical findings.
  • Significant lab values, ECG results, etc.
  • Diagnostic imaging results – if on PACS or CD, please allow team to view images.
  • For intubated patients - please obtain a chest x-ray post intubation.
  • For trauma patients and other patients who may require blood products en route- please obtain 2-4 units packed red blood cells for the transport.

Monitoring and treatment while awaiting transport:
 
  • Do not hesitate to request to speak to the Ornge Paediatric Transport Medicine Physician (TMP) who will provide advice on patient care pending the arrival of the Ornge transport team.
  • For children going to the tertiary care units, the NICUs and PICUs in your region will remain accessible and help with providing advice on diagnostic workup and treatment pending the arrival of the transport team. In the event of changes in your patient’s condition you may call the Regional Tertiary Center for advice and inform the Ornge Control Centre.
 
On arrival, the Ornge transport team will:
 
  • Continue cardio-respiratory monitoring, HR, RR, BP, Oximetry, Capnography.
  • Review temperature, blood sugar and other point of care bloodwork eg. blood gas, lactate, electrolytes.
  • Secure airway for intubated child - Check endotracheal tube (ETT) position (clinical and CXR) and will ensure that the tube is securely taped.
  • Stabilize the child on transport ventilator as appropriate.
  • Ensure all intravenous lines are working, and placed securely on infusion pumps with all medications double checked for transport.
  • Administer any drugs or treatments required by TMP prior to departure.
  • Transfer child onto special transport equipment.
  • Speak to parents and family regarding patient’s condition, plans for transport and destination.
  • Endeavour to bring a parent or other family member with the child for the transport.
  • Provide an update on patient condition and expected time of arrival to the destination hospital - preferably done by the Paediatric TMP.


Want more information?
A Communications Officer is available 24/7 in our Operations Control Centre to address any concerns you have by calling 1.800.387.4672.

Out of Province Transports

Ornge is responsible for the provision of aero-medical services to residents in the Province of Ontario for treatment within the Province of Ontario. When treatment and/or procedures not available in Ontario are required by an Ontario resident, a transfer to a location outside of the province is coordinated by CritiCall or the hospital.

In the event that a non-Ontario resident requires aero-medical transportation while in Ontario, the same processes apply, including transporting the patient to the most appropriate medical facility (as determined by CritiCall or the hospital), subject to the same permissions for transfer to a location outside of Ontario. Non-Ontario residents may be billed for the cost of transport. Information regarding ambulance service billing for Ontario residents, visitors from other provinces and visitors from other countries is available in the Ambulance Service Billing section of the Ontario Ministry of Health and Long-Term Care public website.

Should an Ontario hospital require transport of a non Ontario patient, who does not meet the criteria for Ornge services to a facility in the United States, Ornge recommends contacting an aviation charter company. Ornge is not responsible for fees associated with these services. For more information, please visit the OHIP Out of Country Services page on the Ministry of Health and Long-Term Care public website.

If you have any questions or concerns, visit the Healthcare Partner FAQ.