Hospital Transport and Diversion Guidelines


Greenville Memorial


  • Any level trauma patient
  • Significantly ill , violent, psychiatric pediatric patients
  • Stroke Alerts w/ R.A.C.E score > 4 Comprehensive Stroke Center


Greenville Memorial or SFH Downtown


  • Uncooperative / violent adult patients
  • STEMI Alerts
  • ACS patients
  • Post arrest patients
  • Sexual assault patients
  • Dialysis Patients with dialysis related complaints
  • Suspicion of leaking Aortic Aneurysm; determined by age, presentation and physical exam.
  • Obvious Hip Fractures


GMH, Greer, SF Downtown, SF Eastside, PMC


  • Stroke, TIA (R.A.C.E score < 4)


Greenville Memorial, SFH Eastside, or Greer Memorial


  • OB patients greater than 14 weeks with OB complaint




  • With With a R.A.C.E score of ≥ 4 recommend transport to a comprehensive stroke center (Greenville Memorial)
  • Any acute coronary syndrome patient that presents a high suspicion for need of intervention should be transported to a PCI capable hospital.
  • Once the destination hospital has been determined, the EMS crew must call the receiving facility via a recorded line as soon as possible. The report should include Age, Sex, Chief complaint, & Vital signs.
  • A more complete report should be given for higher acuity patients.
  • Any deviation of this Hospital Destination Guideline should be made by the diverting physician on a recorded line.
  • Behavioral patients should be evaluated on a one-by-one basis by the EMS crew and will be transported to the nearest, most appropriate facility.
  • Every attempt should be made to transport all OB patients to the hospital in which their OB physician is located.
  • The patient retains the right to refuse a diversion. In these cases notify the receiving hospital that the diversion was refused by patient, and have the patient sign a refusal declining the recommendation to divert to a more appropriate facility.