Can we initiate care on a patient at the hospital?

The preferred answer is no, not routinely.

The ALS Patient Care Standards apply to prehospital care. Once the ambulance has arrived at the receiving facility, the patient enters a shared-care environment with the hospital. Paramedics may continue treatment that was started before arrival to achieve the intended goals of care, but they should not routinely initiate a new treatment after entering the facility.

For example, if a patient develops nausea or vomiting while waiting for triage or during an offload delay, the crew should first notify the triage nurse, advocate for timely assessment and treatment, and request that the patient be offloaded when appropriate.

In exceptional circumstances, where the patient has an ongoing clinical need and reasonable efforts to obtain hospital treatment have been unsuccessful, the paramedic should contact a base hospital physician before initiating a new treatment. Any treatment provided should also comply with the paramedic service’s policies regarding patient care while in a receiving facility.