What/Who determines where the ambulance will take the patient?
If the patient is conscious and competent to make their own decisions, they can select which appropriate hospital they wish to be transported to (if in the paramedic’s opinion, they are stable and by-passing a closer facility would not potentially jeopardize the patient’s condition). They can also refuse transport if they sign a liability waiver indicating they understand the risks of not seeking further medical treatment. However, if the patient is unconscious, in an altered mental state, in custody of the police or may be a danger to himself or others, the Paramedic on scene will determine the most appropriate facility for medical treatment. There are also county protocols which the ambulance crew are required to follow which may affect the destination, e.g., patients who the police have determined to be not competent must be taken to the closest facility per protocol.
