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Some would say that this would depend on the call. Does it? Is your family going to feel the same way if you do not come home from work because your local hospital didn't want to wait until conditions improved to send that angina patient to a higher level of care? Would it be different for a level 1 STEMI? I am sure that this could be viewed several different ways. Some would say that it's worth it to risk your own life to take a patient to get the level of care he/she needs. I think that it is an unnecessary risk for me AND the patient. Not all transfers are emergent, or even urgent for that matter. What about a high risk delivery? We can do "What if" all day long. But there is one simple fact. The patient is in a much more stable environment in the hospital where they are, and not out in dangerous conditions. This may be a good topic in your local EMS system to find out when you do, or when you don't transfer a patient over a long distance in poor weather, or poor road conditions.

Local calls emergent calls can usually be accomplished in winter driving conditions by use of local resources. I have been on calls where we had to have a plow lead us to the call, and back. Some of my less fortunate colleagues tried that on a rural call and ended up getting stuck at the bottom of a hill, along with the snow plow. So it doesn't ALWAYS work, but usually it's better than nothing. Luckily they had plenty of fuel and no patient on board.

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