Policy 8–Freestanding Emergency Centers

What type of patient condition is generally appropriate for a Freestanding Emergency Center (FEC)?

An uncomplicated medical condition with a high likelihood of discharge (e.g., abdominal pain with normal vitals, uncomplicated nausea/vomiting/diarrhea, flu-like symptoms, sore throat, minor respiratory infection, ear ache, cough/rash, painful urination).

What musculoskeletal and wound conditions are appropriate for an FEC?

Uncomplicated musculoskeletal injuries (including closed fractures/dislocations with intact neurovascular status), and lacerations/abrasions not requiring surgical intervention.

What two other general conditions must be true to consider FEC transport?

Spinal precautions are not indicated, and trauma activation is not expected.

What age range is a contraindication for FEC transport?

Younger than 2 years old or older than 64 years old.

What cardiac-related findings are contraindications for FEC transport?

STEMI or high-risk chest pain, or possible ACS in patients over 40 years old, or cardiac/traumatic arrest.

What neurologic findings are contraindications for FEC transport?

Suspected stroke or stroke-like symptoms, altered mental status, or potential for neurologic involvement.

What pregnancy-related finding is a contraindication for FEC transport?

Pregnancy over 20 weeks gestation.

What hemorrhage-related finding is a contraindication for FEC transport?

Hemorrhage requiring wound packing or tourniquet use.

What trauma criteria automatically rule out FEC transport?

Significant penetrating trauma, ischemic extremities, angulated long bone or open fracture/open joint dislocation, or spinal motion restriction indicated.

What other judgment-based factor rules out FEC transport?

Paramedic judgment that the patient will need surgery or suspected inpatient admission.

What heart rate range is required for FEC transport eligibility?

60 to 130 bpm.

What systolic BP range is required for adult FEC transport eligibility?

110 to 160 mmHg.

What pulse oximetry, glucose, and GCS values are required for FEC transport eligibility?

Pulse ox greater than 92%, blood glucose between 70-300 mg/dL, and GCS of 15.

If vital signs fall outside the acceptable range for FEC transport, what should EMS tell the patient?

That they may need to be admitted to the hospital, surgical suite, or cath lab, and that going to an FEC may delay their care — EMS strongly suggests a hospital-based facility instead.