Why BLS units still transport to MAR during hospital diversions in Los Angeles County

What is the reason a hospital may divert a BLS unit?

• A. BLS units can only transport to a MAR
• B. BLS units may divert to any available hospital
• C. BLS units transport to a MAR regardless of diversion status
• D. BLS units must return to base during a diversion

Answer: (C)

The correct answer highlights that BLS (Basic Life Support) units transport patients to a MAR (Medical Access and Resource) facility regardless of the diversion status. In the context of emergency medical services, a MAR is a designated facility that is recognized for its capabilities to provide appropriate care for patients being transported. When a hospital is on diversion, it means they are temporarily unable to accept new patients due to various circumstances such as high patient volume or lack of resources. However, BLS units are still required to transport patients to a MAR facility to ensure that the patient receives the necessary medical attention without unnecessary delays. This transport protocol ensures that patient care remains a priority and that BLS units effectively fulfill their duty of care within the established framework of emergency medical services. Understanding the rationale behind patient transport protocols, especially in diversions, is crucial for maintaining effective emergency care and ensuring that patients receive timely treatment.

Outline to guide the read

• Set the scene: why BLS, MAR, and diversion matter in real life EMS.

• Define key terms in plain language: BLS, MAR, hospital diversion.

• Explain the rule: BLS transports to a MAR regardless of diversion status.

• Why this rule exists: patient care and timely access to services.

• How it plays out in Los Angeles County: coordination, channels, and practical impact.

• What this means for crews, hospitals, and patients.

• Quick takeaways and a grounding analogy to keep it memorable.

What happens when a hospital is at capacity? A practical look at BLS, MAR, and diversion

Let’s start with the basics, because this is one of those topics where the terms can feel like a tangle if you try to overthink them. In the field, emergency medical services (EMS) teams—specifically Basic Life Support (BLS) units—are the first medical responders you call when someone’s in distress. They’re trained to stabilize, assess, and transport. On paper, there’s a lot of moving parts that keep the system humming: triage, transport destinations, and hospital capabilities. One common question concerns what happens when hospitals say, “We’re on diversion.” If you’ve ever wondered about the decision logic behind where patients go, you’re not alone. Here’s the core idea in plain terms: BLS units transport patients to a MAR, a Medical Access and Resource facility, regardless of diversion status. Let me unpack that.

What MAR means and why it matters

MAR stands for Medical Access and Resource facility. It’s a designated hospital or facility that’s recognized for its ability to provide the right level of care for a patient at that moment. It’s not the same as “the closest hospital” or “the one with the prettiest lobby.” It’s about capabilities—imaging, specific kinds of monitoring, bed space for certain conditions, or ready access to certain services. In the chaos of an emergency, you want a destination that lines up with the patient’s immediate needs. The MAR concept helps dispatchers, crews, and hospitals keep care efficient and predictable, even when the system is stretched.

Diversion: what it does to the system

Diversion is a status a hospital may take when it can’t safely accept more patients at that moment. Reasons vary: high patient volume, staffing shortages, limited bed space, or the need to focus on critical cases. When a hospital is diverting, it isn’t closed to all arrivals. It just means the incoming flow needs to be more selective, and some patients may be directed elsewhere to avoid bottlenecks or compromised care. Diversions are a pragmatic signal to EMS that another hospital may be a better fit right now, given the patient’s needs and the facility’s capacity.

So, what about BLS transport during a diversion? Here’s the practical answer: BLS units transport to a MAR facility regardless of diversion status. Put differently, even if the hospital you might otherwise pick is on diversion, the BLS unit doesn’t simply park and wait. It still aims for a MAR—a facility equipped to provide the appropriate care—while taking into account the diversion status. The goal is to connect the patient with the needed evaluation or stabilization as quickly as possible, without relying on a single hospital’s available bed at that exact moment.

Why this rule exists: keeping patients moving toward care

You might wonder, “Why not wait for the diversion to lift?” The answer is straightforward: time matters. In emergency care, delays can shift outcomes in meaningful ways. When a BLS unit transports to a MAR, it’s about preserving a continuum of care. The MAR designation signals a match between patient needs and hospital capabilities, even in a crowded system. If the closest hospital is on diversion, there’s a risk of longer waits, repeated handoffs, or insufficient stabilization before definitive care. By design, MAR facilities are the anchors that help EMS keep patient care moving smoothly while the larger system works through the surge.

Think of it like a busy highway with ramp meters. When there’s congestion, you don’t just stop at the ramp; you’re guided to the next available lane or exit that can keep you moving toward your destination. In EMS terms, MARs act as the reliable exits that ensure the patient is steered toward appropriate care without unnecessary detours.

A closer look at how this works in Los Angeles County

Los Angeles County presents a vast, dynamic canvas for EMS. The county’s EMS system coordinates a network of BLS units, Advanced Life Support (ALS) units, transport protocols, and hospital capabilities. Here’s how the rule plays out on the ground:

• Dispatch and triage: When a call comes in, dispatch teams gather information about the patient’s condition and symptoms. They weigh the level of care needed and start identifying potential MAR facilities that can handle the case.

• Diversion awareness: Hospitals may report diversion status, and EMS teams incorporate that data into their destination decisions. The priority remains patient-centered care: where can this patient receive appropriate, timely treatment?

• Destination decision: If the patient’s needs align with MAR capabilities, the BLS unit heads to a MAR facility even if other hospitals nearby are diverting. The MAR designation helps ensure care that matches the clinical picture—stabilization, observation, or transfer to a higher level of care if necessary.

• Handoff and throughput: Once the patient reaches a MAR, clinicians there can continue the evaluation, coordinate with ED teams, and determine the next steps (observation, admission, or transfer to a higher-acuity unit if needed).

This framework keeps the system from grinding to a halt when one hospital reaches capacity. It also reduces the risk of multiple ambulances arriving at the same crowded ED, each waiting for a bed or a definitive assessment. In practice, patients get connected to appropriate care faster, and EMS can move on to the next call—without sacrificing safety.

What this means for frontline crews and hospitals

For BLS crews, the implication is clear: your job isn’t just about getting someone to any hospital; it’s about transporting to a facility that can meet the patient’s needs as soon as possible. That means:

• Clear communication: You’ll need to relay patient status, symptoms, and any special considerations to the MAR facility so the receiving team can pick up where you left off.

• Flexibility: If a MAR is identified as the best fit but a different hospital is temporarily more convenient due to distance or traffic, the prioritized goal remains the patient’s best interest.

• Documentation: Accurate notes about why a MAR was chosen, diversion status, and any changes in patient condition help the chain of care work smoothly.

Hospitals, on the other hand, benefit from a predictable flow. MAR facilities become reliable nodes in the network—ready to accept cases that align with their capabilities, even when the wider system is pressed for space. That predictability helps hospitals optimize staffing, bed management, and interfacility transfers.

A few real-world flavors to anchor the idea

Imagine a busy weekday with multiple incidents. A BLS unit responds to a chest-pain presentation. The closest hospital is on partial diversion but has a MAR bed ready for a cardiac evaluation. The crew transports there, where the ED team can perform an immediate ECG, arrange troponin testing, and coordinate with cardiology if needed. A few blocks away, another hospital might be clear, yet it lacks the specialized capability for rapid cardiac workup. In this scenario, going to the MAR to secure appropriate care faster beats a detour to the purely “nearest” hospital.

In another scenario, a pediatric case arrives with ambiguous symptoms. A MAR facility with pediatric capabilities becomes the right choice because it can tailor the initial assessment and stabilize the child with the right expertise rather than bouncing between facilities.

These stories aren’t just hypotheticals. They reflect a design woven into EMS policy: prioritize patient needs, use MARs strategically, and keep the system moving so nobody sits idle on a hard-to-justify delay.

What learners can take away on the ground

If you’re a student or professional sizing up Los Angeles County’s EMS landscape, a few takeaways anchor the bigger picture:

• MAR is a guiding concept, not a single building. It’s a designation signaling a facility’s readiness to meet the patient’s needs.

• Diversion status shapes destinations, but it doesn’t freeze decision-making. The aim is continuous, appropriate care.

• Communication is king. The more precise your patient information and rationale for MAR use, the smoother the handoff and the next steps.

• Real-world practice blends theory with street-smarts: know the major MAR facilities in your intake area, understand their capabilities, and stay aware of diversion patterns so you can advocate for the right match quickly.

A mindful, humane approach to EMS decisions

Beyond the mechanics, there’s a human element that deserves attention. When a patient or a family member asks, “Where are we going and why?” it’s not just about the numbers. It’s about trust. The MAR-based routing is designed to respect that trust by making sure care matches need, not simply distance. Emergency care can feel chaotic, with sirens and hurried voices, but the goal remains steady: get the right care to the right person, at the right time.

If you’re mapping this out for learning or professional growth, think of it as building a habit of clarity under pressure. You’re never merely moving a patient from point A to point B. You’re guiding someone through a critical moment with competence, compassion, and a clear sense of how the system can best support them.

Final takeaway: a practical lens on a practical rule

In the end, the rule—BLS units transport to a MAR facility regardless of diversion status—rests on a simple premise: patient care is the priority, and MARs are the trusted way to match care with capability. It’s not about gaming the system or chasing the nearest road; it’s about ensuring timely access to the right services, even when the hospital landscape is busy, crowded, or shifting.

If you’re studying the broader landscape of Los Angeles County accreditation and EMS standards, this principle shows how policy translates into field reality. It’s a reminder that every decision in the field—every mile covered and every handoff performed—connects to a larger goal: delivering capable, timely care to people when they need it most.

And if you’re curious for a quick mental cue, remember this: when a hospital is diverting, the BLS unit doesn’t skip a beat. It looks to the MAR, and it keeps moving toward care that can truly help. That’s the heart of the system in action.