MD consult
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
II
|
Supportive (Green)
|
Supportive of MD consult/tele-medicine as a potential alternative to ED transport
|
Process
|
Other
|
Cortellaro F, Taurino L, Delorenzo M, et al. Implementation of Telemedicine for Patients Referred to Emergency Medical Services. Epidemiol. 2025; 6(3). Medline
|
|
III
|
Supportive (Green)
|
Transfer avoidance
|
Patient
|
PH-Paramedic & MD
|
Davis CA, Supples MW, Anderson MB, et al. Can Emergency Medical Services Telehealth Prevent Interfacility Transfers in Patients with Chest Pain? Prehosp Emerg Care. January 2026; 1-14. Medline
|
|
X
|
Not Yet Graded (White)
|
-
|
|
|
Varughese R, Cater-Cyker M, Sabbineni R, et al. Transport Rates and Prehospital Intervals for an EMS Telemedicine Intervention. Prehospital Emerg Care. 2024; 28(5):706-711. Medline
|
|
X
|
Not Yet Graded (White)
|
-
|
|
|
Young-Jamieson J, Bekkeli R, Michael A, Smithson R. Feasibility of a Pre-Hospital Virtual Triage and Care Model: A Mixed-Methods Pilot in Emergency Care. Emerg Med Australas. 2025; 37(6):e70168. Medline
|
MD video consult
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
X
|
Not Yet Graded (White)
|
-
|
|
|
Balasubramanian S, DeFilippo M, Stone M, Galli G, McCarty M, Daniels B. Pneumothorax Identified by a Remote Physician Using Paramedic-obtained Tele-ultrasound: Case Report. Clin Pract Cases Emerg Med. 2024 Aug;8(3):189-193. doi: 10.5811/cpcem.1296. PMID: 39158228; PMCID: PMC11326067. Medline
|
|
X
|
Not Yet Graded (White)
|
-
|
|
|
Mahony E, Magnuson N, Thornton A, et al. Utilisation of an emergency medical services pathway into a virtual emergency department and the impact on non-transports and patient safety. Emerg Med J. 2025. Medline
|
|
X
|
Not Yet Graded (White)
|
-
|
|
|
Nehme E, Flaus C, Clarke S, et al. Video triage by emergency medical service secondary triage clinicians in Victoria, Australia. J Telemed Telecare. 2025; 1357633X251383395. Medline
|
|
X
|
Not Yet Graded (White)
|
-
|
|
|
Tse T, Jardine AGM, Taylor L, et al. A Virtual Emergency Department Reduces Unnecessary Transfers to Hospital of Residential Aged Care Residents Who Fall With Headstrike. EMA - Emerg Med Australas. 2025; 37(3):1-7. Medline
|
|
X
|
Not Yet Graded (White)
|
-
|
|
|
Ulvin OE, Skjærseth EÅ, Krüger AJ, Thorsen K, Nordseth T, Haugland H. Can video communication in the emergency medical communication centre improve dispatch precision? A before–after study in Norwegian helicopter emergency medical services. BMJ Open. 2023; 13(10):1-10. Medline
|
Non-Transport
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
II
|
Supportive (Green)
|
30 day mortality
|
Patient
|
PH-Paramedic & MD
|
Heinonen K, Puolakka T, Salmi H, Boyd J, Laiho M, Porthan K, Harve-Rytsälä H, Kuisma M. Ambulance crew-initiated non-conveyance in the Helsinki EMS system-A retrospective cohort study. Acta Anaesthesiol Scand. 2022 May;66(5):625-633. doi: 10.1111/aas.14049. Epub 2022 Feb 28. PMID: 35170028; PMCID: PMC9544076. Medline
|
|
II
|
Supportive (Green)
|
identification of serious conditions
|
Patient
|
PH-Paramedic
|
Ivic-Morén R, Bohm K, Vicente V, Arvidsson E, Castrén M, Kurland L. Serious conditions among conveyed and non-conveyed patients presenting with nonspecific chief complaints to the ambulance service. BMC Emerg Med 2024; 24(1):199. Medline
|
|
II
|
Supportive (Green)
|
Adverse events occurring within 48 hours of index non-transport episode
|
Process
|
PH-Paramedic
|
Nehme E, Nehme Z, Cox S, Smith K. Outcomes of paediatric patients who are not transported to hospital by Emergency Medical Services: a data linkage study. Emerg Med J. 2023 Jan;40(1):12-19. doi: 10.1136/emermed-2022-212350. Epub 2022 Oct 6. PMID: 36202623. Medline
|
|
II
|
Supportive (Green)
|
Bounce back
|
Process
|
PH-Paramedic
|
Speijers RF, Ebben RHA, Eikendal T, Ruijs L, Cuppen FGMHM, de Vos R. An analysis of characteristics and associated factors for re-contacts after EMS non-conveyance: a retrospective cohort study in the Netherlands. Scand J Trauma Resusc Emerg Med. April 2025; 33(1):64. Medline
|
|
II
|
Supportive (Green)
|
Non-transport relapse rate for three presentations.
|
Process
|
PH-Paramedic
|
Strum RP, Mondoux S, Costa A, McLeod B, Dodd T, Turcotte K, Miller P. Short-Term Outcomes of Paramedic Treat and Discharge: A Cohort Study of Emergency Service Use in Ontario, Canada. Prehosp Emerg Care. 2025 Jul 8:1-8. doi: 10.1080/10903127.2025.2525528. Epub ahead of print. PMID: 40586666. Medline
|
|
II
|
Supportive (Green)
|
pt outcomes within 72- hour of non transport
|
Patient
|
PH-Paramedic
|
Villani M, Nehme E, Cox S, Anderson D, Reinders N, Nehme Z. Outcomes of adult patients discharged at scene by emergency medical services. Emerg Med J June 2024. Medline
|
|
II
|
Neutral (Yellow)
|
Characteristics of non-transport for falls of the elderly.
|
Process
|
PH-Paramedic
|
Joiner A, Fernandez AR, Van Vleet L, Cabañas JG, Grover J, Godfrey A, Crowe R, Staton C, Pavon J. Predictors of Non-Transport for Older Adult EMS Patients Encountered for Falls. Prehosp Emerg Care. 2023;27(7):859-865. doi: 10.1080/10903127.2022.2137744. Epub 2022 Oct 28. PMID: 36251394. Medline
|
|
II
|
Opposes (Red)
|
Repeat calls
|
Patient
|
PH-Paramedic
|
Moore EA, Schoenfeld DW, Fritz CL, Bivens MJ, Liu SW, Thomas SH. Geriatric “lift-assist” EMS calls with transport refusal: Characteristics of short-term repeat calls and hospitalizations. Am J Emerg Med Sept 25; 95:77-82. Medline
|
|
III
|
Supportive (Green)
|
re-contacts within 72 h after non-conveyance
|
Patient
|
PH-Paramedic & CCT
|
de Loor SE, Verheij T, Karol T, et al. An analysis of ambulance re-contacts after non-conveyance: a retrospective cohort study in the Netherlands. Scand J Trauma Resusc Emerg Med Feb 2025; 33(1):17. Medline
|
|
III
|
Supportive (Green)
|
Repeat presentation after non-transport
|
Patient
|
PH-Paramedic
|
Dorsett M, Allen H, Garbacz H, et al. Timeline for repeat EMS encounters resulting in transport following “lift assist” in a suburban EMS system. Prehosp Emerg Care May 2025; 1-20. Medline
|
|
III
|
Supportive (Green)
|
EMS recontact rates
|
Patient
|
PH-Paramedic
|
Heinonen K, Kuisma M, Puolakka T. Patients discharged to police custody after paramedic evaluation: an observational cohort study. Emerg Med J. April 2025. Medline
|
|
III
|
Supportive (Green)
|
Hospital encounters
|
Patient
|
PH-Paramedic
|
Höglund E, Schröder A, Andersson-Hagiwara M, Möller M, Ohlsson-Nevo E. Outcomes in patients not conveyed by emergency medical services (EMS): a one-year prospective study. Scand J Trauma Resusc Emerg Med. 2022 Jun 13;30(1):40. doi: 10.1186/s13049-022-01023-3. PMID: 35698086; PMCID: PMC9195370. Medline
|
|
III
|
Neutral (Yellow)
|
Further care sought within 72 hours
|
Patient
|
PH-Paramedic
|
Larsson G, Eldh J, Hagman E, M AH. The non-conveyance of trauma patients in Swedish emergency medical services: a retrospective observational study of the trauma population not transported to an emergency department. BMC Emerg Med February 2024; 24(1):34. Medline
|