Hospital Capabilities

Specialty/Capability What can the hospital do? Referral Indications
Cardiac A cardiac center has a cath lab. You can take a patient there who is having an MI, and they will be able to be assessed and treated on-site. Patients you suspect are having a cardiac event.
Stroke - Primary A stroke center has a 24-hour stroke team, imaging capabilities, and OR capabilities to immediately administer fibrinolytics. Any patient who is positive for stroke symptoms with a LAMS score of 3 or less.
Stroke - Thrombectomy-Capable Can perform roles of a primary stroke center AND mechanical thrombectomy, a minimally invasive surgical procedure to remove a blood clot from an artery and post-procedural care. Any patient who is positive for stroke symptoms with a LAMS score of 4 or 5.
Stroke - Comprehensive Offers the full spectrum of advanced treatments for both ischemic and hemorrhagic strokes and is able to treat the most complex stroke cases. Any patient who is positive for stroke symptoms with a LAMS score of 4 or 5.
Psych Pod Hospitals that have a dedicated space for patients experiencing psychiatric emergencies where the person may be a significant danger to themselves or others. Any patient who poses a significant danger of being violent towards themselves or others.
Adult Trauma - Level I 24/7 in-house trauma specialists and ready operating room. Any category A, B, C, or D trauma.
Adult Trauma - Level II Operating room ready 24/7; trauma doctor is onsite during the daytime and 20-minute on-call at night. Any category A, B, C, or D trauma.
Burns This facility has the specific capabilities to handle patients with significant burns that may be life-threatening. Meets burn protocol criteria.
Hyperbaric This facility has the equipment and specialty staff to operate a hyperbaric chamber. History of SCUBA, breathing in a pressurized environment (flight), or altitude chamber with sudden depressurization.
Extremity This facility has the surgical capabilities to perform complicated limb reattachment procedures. Meets Hand/Upper/Lower Extremity trauma protocol criteria.
Eye This facility has personnel and equipment to handle traumatic eye injuries. Significant injury to the eye, including impaled objects, lacerations, avulsions, detached retina, chemical exposures.
Neuro This facility has the personnel and equipment to perform neurosurgery. Patients over 14 years old with new onset traumatic paralysis, patent airway, and hemodynamically stable.
Pediatric Trauma Has doctors and equipment designed for children with severe traumatic injuries to be rapidly assessed and moved into an OR for stabilization. Patients who have not reached their 15th birthday and meet trauma criteria.
Pediatric Burns Has doctors and equipment designed for children with burns to be safely handled. Patients who have not reached their 15th birthday and meet burn criteria.
Pediatric Hyperbaric Has a hyperbaric facility capable of treating children. Patients who have not reached their 15th birthday and meet hyperbaric criteria.
Perinatal Has specialty facilities and teams to handle patients with high-risk pregnancies and/or neonatal patients in need of specialty care (e.g., a NICU). Patients with high-risk pregnancies and/or neonates with complex conditions requiring specialized care.
Pediatric Non-Trauma Facility has equipment and personnel to handle pediatric emergencies. Patients who are under 18 years old.
OB/Prenatal Facility has an L&D ward and personnel trained to handle obstetrics/prenatal emergencies. Patients experiencing any kind of injury or illness related to pregnancy.
Sexual Assault These facilities have personnel trained to handle victims of sexual assault in a way that treats their injuries, preserves evidence for police, and helps victims get the right resources. Patients who are or may be victims of sexual assault.

Hospital Capabilities by Location

Holy Cross (Silver Spring)

Holy Cross Germantown

MedStar Montgomery

Shady Grove (Adventist)

Suburban (JHU)

Walter Reed (Bethesda Naval)

White Oak

Children’s National Medical Center

Medstar Washington Hospital Center

Shock Trauma

Johns Hopkins Hospital

Johns Hopkins Bayview

Practice Interactive Scenarios

3 YOM who accidentally got sunscreen in their eye. Wouldn’t stop crying so babysitter called 911.

30 YOM construction worker, chain saw chain snapped and hit his face/eye. Swelling and tenderness around orbital but no obvious cuts to the eyeball.

16 YOM accidentally shot in eye with BB gun. BB didn’t penetrate eyeball, but scratched eye.

20 YOM, drunk and playing around with BBQ skewers with his friends. Gets one impaled in his eye. Doesn’t go into brain. Vitals stable but in pain.

18 YOF playing golf, ball hits her in the eye in just the right way and eyeball comes out of socket. Vitals stable, complaining of headache, freaked out about eyeball dislodgement.

Grocery store employee got three fingers chewed up in a meat grinder. Bleeding controlled with pressure dressing. Two fingers up to 2nd knuckle are grinded up.

Another grocery store employee accidentally got his finger partially sliced off in a deli meat slicer. The finger is sliced about ⅔ of the way through between the 1st & 2nd knuckles.

35 YOM got his foot run over by a lawn mower. Several lacerations, and two toes sliced off completely. Bleeding controlled with a tourniquet. Vitals stable.

12 YOF accidentally sliced her hand open while trying to cut vegetables making dinner. Parents saw blood spurting and put a homemade tourniquet on (learned from scout camp), which is controlling bleeding. Can’t feel anything in fingers and can see that cut is about ½ way through palm.

19 YOF who was sexually assaulted at a party. As you walk up to her you notice some small cuts and scrapes on her face and arms, but no other visible injuries. Her vitals are stable and she is AOx4.

10 YOM in the custody of MCPD. Called due to possible child abuse allegations and reports that child was recently sexually assaulted. Patient has no outward physical injuries and is not complaining of any pain.

Additional Hospital Knowledge

How to check if a hospital is on diversion status:

How does an EMS unit request to place a hospital on reroute?

What is EMS700?

When is EMS700 in service?

Describe the circumstances when you are required to communicate with EMS700:

Scenario: Georgia Ave/Randolph Road Transport Decision

You are at Georgia Ave/Randolph Road with a stable priority two patient experiencing shortness of breath. Holy Cross Silver Spring, White Oak, Suburban, and MedStar Montgomery are all on red and yellow. The patient has no preference in hospital destination. Where do you transport them?

Answer: Transport to Holy Cross Silver Spring. If the two closest hospitals are on yellow, an EMS unit may transport to the closest appropriate facility.