A Coordinated Approach for Critical Care Transport
One of the most vital components of the Lifeline program is the communications center, which provides centralized coordination of all transportation activities for the Johns Hopkins Health System. Situated in the Capacity Command Center at The Johns Hopkins Hospital, the Lifeline communications personnel work directly with care team members from the referring facility, the Johns Hopkins Health System, and our transportation partners to provide appropriate medical transportation in a safe and efficient manner. The dedicated communications center operates 24/7 to coordinate medical ground and air transportation services for domestic and international transport.
Requests for interfacility transport are initiated by the Hopkins Access Line (HAL) via a toll-free number (1-800-765-5447) and relayed to the communications center for immediate dispatch. This system allows for a patient transport to be initiated by a “one-call” method for referring physicians and is a cornerstone in the transport process.
Lifeline communications personnel are medically trained emergency medical technicians and paramedics, who have extensive knowledge of all aspects of patient transport and the Johns Hopkins Health System.
The attending physician should contact the Hopkins Access Line (HAL) to request a transfer: 1-800-765-5447.
Please have the following information available:
- Attending physician name, specialty and contact number
- Primary care physician name and address (if available)
- Patient location. If at a hospital, please provide the unit, floor, room number and telephone number of the nurses’ station
- Diagnosis and plan of treatment or procedure (e.g., cardiac catheterization, coronary artery bypass grafting, neurosurgery, etc.)
Once the patient has been accepted:
- Provide a copy of the patient’s demographic sheet to the HAL coordinator, including insurance information to be used for financial clearance. Please fax information to 1-410-614-2183.
- A Lifeline coordinator will contact the nursing unit for brief clinical triage information to determine appropriate method of transport. (Factors such as clinical acuity, weather, distance and traffic patterns will be considered.)
- To expedite the transfer and limit bedside time, have the following items ready for the transport team when they arrive.
- Discharge/transfer summary
- History and physical examination
- Medication list
- Emergency Medical Treatment and Labor Act (EMTALA)/Consolidated Omnibus Budget Reconciliation Act (COBRA) transfer forms completed and signed from referring hospital/institution
- Certificate of medical necessity (CMN)/physician certification statement (PCS) forms completed and signed
- Any hard copies of X-rays/films that will be needed by the receiving physician
Please visit the Johns Hopkins Medicine website for additional information about directions and parking for The Johns Hopkins Hospital for families.
Transfer a Patient from within Hopkins to another facility:
Contact the HAL line at 5-5447 and provide the following information:
Please provide the name and pager number of the staff member that is requesting the transport (nurse, social worker).
- Date and Time of transport.
- Patient Demographics
- Pick up location and full address of the destination with phone number to the receiving floor.
- Transport Information: Is this a one way trip? Multiple Trips? etc.
- Level of Care: BLS, ALS, CCT, Wheel Chair, By Airplane?
- Non-Medical Transport by Taxi, Sedan, Executive Sedan?
- Medical Information: Admitting/Discharge Diagnosis, Medications, IV's, O2, Isolation, Cardiac Monitor, Restraints, State DNR with Cert, Weight of patient, and any Steps?
- For a Medicare Patient, can patient sit up? YES or NO.
- Patient Insurance - Primary, Secondary and Payment Information.
- Yellow Taxi Transports: Account number for ALL transports with and authorized caller name from the referring department.
- All medical transports can be paid by Check, Cash or Credit Card.
- A Lifeline Communications Staff member will then call the floor and provide ETA
or provide further information as needed.
If a patient is not going to another in-patient facility (such as going home), the Lifeline communications office can be contacted directly at 410-614-7777 for transportation arrangements.
Contact the Pediatric Transport Team at 410-955-9444 and ask to speak to the transport fellow or nurse. The following information will be needed:
- Patient's name, age and weight
- Clinical presentation and chief complaint
- Diagnostic studies done at your facility
- Treatment provided at your facility
- Current vital signs
- Patient's past medical history and allergies
- Routine home medications
- Isolation status and last oral intake
- Patient's insurance information for transport vendor
Preparing the Transfer Chart
To decrease the time the transport team is at your facility, prepare copies of all medical records and a hard copy of all radiology studies. The radiology department at Johns Hopkins is not always able to open up all types of electronically stored images, therefore hard copies are preferred. The transport team does not like to transport lab specimens due to the risk of breakage or potential alteration of lab results. The transport team or admitting physician will contact the lab at your facility for lab results.
For non-emergent transfers a signed consent form must be available in the chart. A telephone consent may be documented by the attending physician if the parent or guardian is not present. In an emergency, two physicians may document in the chart the emergency need for transfer and the reason consent cannot be obtained (e.g. parent is unconscious). If necessary the second physician may be the receiving physician. In emergency situations, transport will not be delayed to obtain consent.
Preparing the Patient for Transfer
- Secure all lines and tubes. If possible, unstable patients should have two large bore IV's in place.
- Confirm ET tube placement with exhaled carbon dioxide detector (capnography preferred) and a chest x-ray if possible. A CXR is especially important in young children.
- All patients should be NPO for transport. Patients who are transferred may need sedation and a maintenance IV fluid. The PICU transport team can give these recommendations when consultation is initially obtained.
- Patients who are coming to the pediatric trauma center will need to be immobilized with a collar and backboard prior to transfer. The team will immoblize the patient upon arrival however if this has already done, it will reduce the bedside time at your facility.
- Children are at risk for hypothermia, therefore a recent temperature is helpful in determining appropriate warming measures during the transport.
Preparing the Family for Transfer
If possible, the transport team will transport one family member with the patient. If the patient is being transported by Helicopter, the team will have to consider the weight of the entire team to determine if a family member will be allowed to go with the patient. Siblings will not be transported. Recorded driving directions to Hopkins if needed are available by calling 410-955-0166.
Patient Follow Up
Staff who cared for the patient at the sending facility may call the Transport Office at 410-502-2961 and leave a message for patient outcome information or email to JHHPedTransport@jhmi.edu. ANY CONCERNS RELATED TO THE PEDIATRIC TRANSPORT SERVICE MAY BE DIRECTED TO THE Transport Team Coordinator, Philomena Costabile at email@example.com, or Team Medical Director, Dr. Kristen Nelson McMillan at firstname.lastname@example.org, or Director, Dr. Bruce Klein at email@example.com.