• Status post cardiacarrest (within 24 hours) or acute MI patients
• Unstable vital signs or titrating vasoactive infusions
• Requires mechanical ventilation
• Unstable airway
• Anti-dysrhythmia medications or temporary pacemaker to maintain cardiac stability
• Acute deterioration of mental status, including the stroke patient
• Immediate invasive therapy required at a hospital
• Indwelling arterial and central venous lines
• Organ transplant patients
• Invasive, therapeutic, or diagnostic services not available at a referring facility
• Uncontrolled seizures