Clinical escorts

Clinically depend patients must have a medical escort provided and are identified as patients who: 

• Require medication en route.
• Require vital sign monitoring or neurological monitoring.
• Have IV fluids or infusion running.
• Are incontinent or require assistance with toileting.
• Are highly likely to become nauseous because of their condition or medication.
• Have a lowered level of consciousness.
• Are confused, irritable or restless.
• Cannot verbalise their needs.
• Have an intellectual disability.
• Have acute psychiatric illness or have behavioural problems that could pose a transfer safety issue.
• Are in active labour.
• Have a condition that may destabilise en route.
• Are unable to alter their own position for comfort or necessity.
• Are under the age of sixteen and do not have an adult caregiver to accompany them.
• Have a dependent child or infant travelling with them.
• Are being transferred as an urgent case.
• Require nursing care during or after their appointment.

Patients remain the responsibility of the DHB at all times during a transfer of a patient. Clinical escorts must have appropriate knowledge and skills to adequately care for the patient during the transfer. 

Clinical escort staff should: 

• Travel with the Patient in the back of the ambulance.
• Look after the medical and comfort requirements of the Patient.
• Advise the ambulance transfer officer of any problems en route.
• Provide a Patient briefing with the ambulance transfer officer prior to transfer.
• Comply with the use of passenger and Patient restraint devices fitted in the ambulance.
• Know that St John can organise urgent assistance if there are serious Patient problems en route.

Returning escort staff

When an ambulance is returning to a location close to the originating hospital, St John will endeavour to return the escort staff. This is not guaranteed so escort staff should have available another means of return such as taxi chits if required.

In the case of a patient transfer out of the DHBs area, St John will be responsible for the return of the DHB patient escort staff on a best endeavours basis back to the original point of collection noting that:

• The DHBs accept that on occasion a returning ambulance may have to divert to an emergency incident where they are the closest ambulance; in which case the Patient escort staff may remain with the ambulance while the ambulance crew attend the emergency incident.
• In the interests of efficient use of Patient Transfer Service resources, there may be occasions where a returning ambulance is used to transfer a Patient to a town that requires a diversion from the most direct route. This will be communicated in advance to allow alternative arrangement to be made for the return of the clinical escort if requested.