Guest guest Posted June 1, 2004 Report Share Posted June 1, 2004 This story might be slightly relavent. A couple months back I overheard a call go out over the radio to the cities EMS to go the county hopsital for an injured party. I spoke with one of the guys who made the call and asked what the call was about (thinking it odd that an ALS unit would be dispatched to a hospital for an injured party without say, a request for extrication equipment or something). A middle aged woman slipped and fell in the hospital parking lot about 500 feet from the door to the ER, and the 911 call was made by a hospital employee (an LVN if I remember right). She was A & Ox3, but had wrenched her knee and couldn't walk on her own (even if she had been a " large " person and help were needed to move her, I'm sure some assistance from somebody inside would have been available). I felt that that was a turf issue taken to extream. I do feel however, that if a person is actually in the hospital recieving any level of care and a transfer to another facility is needed it should go through channels. This would not only be for tracking of the patient for billing, but to ensure that somebody has written down who took who to where and who authorized the transfer (thus insuring that the person requesting the transfer for the patient actually has the authority to do so) and also that the proper type of unit is used (no point in trying to use a BLS unit for a patient who might need car that can only be provided by an ALS unit). That is however just my opinion. Crosby EMT-B and Luvin It. Turf Issues > A coworker & I were debating this after she was approached in an ER > last shift. > > What is the proper thing to do if someone on a hospital campus > either calls 911 or walks up to you, and requests transport to > another facility? > > I believe that once on the hospital grounds, they are under the > responsibility of that facility and must go through the facility's > administration for transfer. Am I right? > > Does it matter whether the patient is in the ER waiting room, in > the parking lot, or in the housekeeping shed separate from other > buildings? Does it matter if the patient has already been triaged, > not been triaged yet, or is leaving AMA (though still on the > property)? > > Just to try to prevent some " what if " issues, the patient is in no > apparent distress, just a twisted ankle with stable vitals that is > not being seen fast enough or getting the attention he feels he > needs. I'm not advocating abandoning the patient where he is. I do > recognize the need to bring him to the attention of the ED or > whatever response team the hospital has for on-campus emergencies, > and would activate that team or contact them somehow. > > I'd appreciate your input, especially if you have JD after your > name or work for TDH. > > Thank you, > > Andy Wheeler > > > PS- Does the state conference ever offer CEs on legal issues or > classes on Medicare/Medicaid reimbursements? > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2004 Report Share Posted June 1, 2004 This story might be slightly relavent. A couple months back I overheard a call go out over the radio to the cities EMS to go the county hopsital for an injured party. I spoke with one of the guys who made the call and asked what the call was about (thinking it odd that an ALS unit would be dispatched to a hospital for an injured party without say, a request for extrication equipment or something). A middle aged woman slipped and fell in the hospital parking lot about 500 feet from the door to the ER, and the 911 call was made by a hospital employee (an LVN if I remember right). She was A & Ox3, but had wrenched her knee and couldn't walk on her own (even if she had been a " large " person and help were needed to move her, I'm sure some assistance from somebody inside would have been available). I felt that that was a turf issue taken to extream. I do feel however, that if a person is actually in the hospital recieving any level of care and a transfer to another facility is needed it should go through channels. This would not only be for tracking of the patient for billing, but to ensure that somebody has written down who took who to where and who authorized the transfer (thus insuring that the person requesting the transfer for the patient actually has the authority to do so) and also that the proper type of unit is used (no point in trying to use a BLS unit for a patient who might need car that can only be provided by an ALS unit). That is however just my opinion. Crosby EMT-B and Luvin It. Turf Issues > A coworker & I were debating this after she was approached in an ER > last shift. > > What is the proper thing to do if someone on a hospital campus > either calls 911 or walks up to you, and requests transport to > another facility? > > I believe that once on the hospital grounds, they are under the > responsibility of that facility and must go through the facility's > administration for transfer. Am I right? > > Does it matter whether the patient is in the ER waiting room, in > the parking lot, or in the housekeeping shed separate from other > buildings? Does it matter if the patient has already been triaged, > not been triaged yet, or is leaving AMA (though still on the > property)? > > Just to try to prevent some " what if " issues, the patient is in no > apparent distress, just a twisted ankle with stable vitals that is > not being seen fast enough or getting the attention he feels he > needs. I'm not advocating abandoning the patient where he is. I do > recognize the need to bring him to the attention of the ED or > whatever response team the hospital has for on-campus emergencies, > and would activate that team or contact them somehow. > > I'd appreciate your input, especially if you have JD after your > name or work for TDH. > > Thank you, > > Andy Wheeler > > > PS- Does the state conference ever offer CEs on legal issues or > classes on Medicare/Medicaid reimbursements? > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2004 Report Share Posted June 1, 2004 If the patient has signed himself \ her and for whatever reason does not want to be treated at that facility, you would fall under the same guidelines if a patient at Wal Mart ask you to transport him\her. The hospital may have to document and explain why and how the this occurred. If the hospital was trying to take care of the patient and the patient decided he\she wanted to go to another location, I do not see this as a EMTALA violation. The next receiving hospital may squawk a little. However, if I were the medic making the call, I would make sure to explain the details regarding the original hospital attempting to assist this patient and that the move was the patients choice. If you are a hospital based Service and the first hospital is your base, you may have issues with your superiors if you transport. I would expect the issues would be that the hospital does not want to be placed in a position of even looking like a EMTALA violation. Henry bearamedic99 wrote: > A coworker & I were debating this after she was approached in an ER > last shift. > > What is the proper thing to do if someone on a hospital campus > either calls 911 or walks up to you, and requests transport to > another facility? > > I believe that once on the hospital grounds, they are under the > responsibility of that facility and must go through the facility's > administration for transfer. Am I right? > > Does it matter whether the patient is in the ER waiting room, in > the parking lot, or in the housekeeping shed separate from other > buildings? Does it matter if the patient has already been triaged, > not been triaged yet, or is leaving AMA (though still on the > property)? > > Just to try to prevent some " what if " issues, the patient is in no > apparent distress, just a twisted ankle with stable vitals that is > not being seen fast enough or getting the attention he feels he > needs. I'm not advocating abandoning the patient where he is. I do > recognize the need to bring him to the attention of the ED or > whatever response team the hospital has for on-campus emergencies, > and would activate that team or contact them somehow. > > I'd appreciate your input, especially if you have JD after your > name or work for TDH. > > Thank you, > > Andy Wheeler > > PS- Does the state conference ever offer CEs on legal issues or > classes on Medicare/Medicaid reimbursements? > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2004 Report Share Posted June 1, 2004 If the patient has signed himself \ her and for whatever reason does not want to be treated at that facility, you would fall under the same guidelines if a patient at Wal Mart ask you to transport him\her. The hospital may have to document and explain why and how the this occurred. If the hospital was trying to take care of the patient and the patient decided he\she wanted to go to another location, I do not see this as a EMTALA violation. The next receiving hospital may squawk a little. However, if I were the medic making the call, I would make sure to explain the details regarding the original hospital attempting to assist this patient and that the move was the patients choice. If you are a hospital based Service and the first hospital is your base, you may have issues with your superiors if you transport. I would expect the issues would be that the hospital does not want to be placed in a position of even looking like a EMTALA violation. Henry bearamedic99 wrote: > A coworker & I were debating this after she was approached in an ER > last shift. > > What is the proper thing to do if someone on a hospital campus > either calls 911 or walks up to you, and requests transport to > another facility? > > I believe that once on the hospital grounds, they are under the > responsibility of that facility and must go through the facility's > administration for transfer. Am I right? > > Does it matter whether the patient is in the ER waiting room, in > the parking lot, or in the housekeeping shed separate from other > buildings? Does it matter if the patient has already been triaged, > not been triaged yet, or is leaving AMA (though still on the > property)? > > Just to try to prevent some " what if " issues, the patient is in no > apparent distress, just a twisted ankle with stable vitals that is > not being seen fast enough or getting the attention he feels he > needs. I'm not advocating abandoning the patient where he is. I do > recognize the need to bring him to the attention of the ED or > whatever response team the hospital has for on-campus emergencies, > and would activate that team or contact them somehow. > > I'd appreciate your input, especially if you have JD after your > name or work for TDH. > > Thank you, > > Andy Wheeler > > PS- Does the state conference ever offer CEs on legal issues or > classes on Medicare/Medicaid reimbursements? > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2004 Report Share Posted June 1, 2004 If the patient has signed himself \ her and for whatever reason does not want to be treated at that facility, you would fall under the same guidelines if a patient at Wal Mart ask you to transport him\her. The hospital may have to document and explain why and how the this occurred. If the hospital was trying to take care of the patient and the patient decided he\she wanted to go to another location, I do not see this as a EMTALA violation. The next receiving hospital may squawk a little. However, if I were the medic making the call, I would make sure to explain the details regarding the original hospital attempting to assist this patient and that the move was the patients choice. If you are a hospital based Service and the first hospital is your base, you may have issues with your superiors if you transport. I would expect the issues would be that the hospital does not want to be placed in a position of even looking like a EMTALA violation. Henry bearamedic99 wrote: > A coworker & I were debating this after she was approached in an ER > last shift. > > What is the proper thing to do if someone on a hospital campus > either calls 911 or walks up to you, and requests transport to > another facility? > > I believe that once on the hospital grounds, they are under the > responsibility of that facility and must go through the facility's > administration for transfer. Am I right? > > Does it matter whether the patient is in the ER waiting room, in > the parking lot, or in the housekeeping shed separate from other > buildings? Does it matter if the patient has already been triaged, > not been triaged yet, or is leaving AMA (though still on the > property)? > > Just to try to prevent some " what if " issues, the patient is in no > apparent distress, just a twisted ankle with stable vitals that is > not being seen fast enough or getting the attention he feels he > needs. I'm not advocating abandoning the patient where he is. I do > recognize the need to bring him to the attention of the ED or > whatever response team the hospital has for on-campus emergencies, > and would activate that team or contact them somehow. > > I'd appreciate your input, especially if you have JD after your > name or work for TDH. > > Thank you, > > Andy Wheeler > > PS- Does the state conference ever offer CEs on legal issues or > classes on Medicare/Medicaid reimbursements? > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2004 Report Share Posted June 1, 2004 I think your closing remarks were right on the money. Keep everyone in the loop. 'Tater Salad' Hatfield EMT-P " Caesar si viveret, ad remum dareris " Start getting ready now!!! EMStock 2005!! www.EMStock.com www.temsf.org > What is the proper thing to do if someone on a hospital campus > either calls 911 or walks up to you, and requests transport to > another facility? That would much depend upon you services' SOP's. It's not an EMTALA issue unless the hospital has refused to see the patient etc. If the hospital has already triaged the patient, and no life threatening injuries or illnesses present, than to a certain degree, the hospital has fulfilled it's duties. If the aptient is pissed cause they don't want to wait, that's another story. There is nothign you can do to 'require' the patient to go back to the facility if they don' want to. > > I believe that once on the hospital grounds, they are under the > responsibility of that facility and must go through the facility's > administration for transfer. Am I right? EMTALA states that once they are on hospital grounds, regardless of where they are on the grounds, housekeeping shed seperate from the building etc., the hospital is responsible from an EMTALA point of view. In order for it to be a interfacility transfer, then yes, you would have to go through the administration, get a receiving facility, and docor, and all the other stuff you have to do. The patient has the right to leave, signed paperwork or not for AMA, I have worked in bigger city ER's where seom just get up go outside to smoke, and never return. In Fayetteville, I got a 911 call from the payphone in an ER waiting room. > > Does it matter whether the patient is in the ER waiting room, in > the parking lot, or in the housekeeping shed separate from other > buildings? Does it matter if the patient has already been triaged, > not been triaged yet, or is leaving AMA (though still on the > property)? It only matters to the hospital whose grounds they are on. For example, employee A gets injured on the grounds, and although they are an employee of the hospital, they choose to go to another facility, call 911, and tell you that they want to go to the hospital on the other side of town. The hospital would most likely wnat to cover their a**, and understandably so. The receiving facility will be irked as the patient was already at a hospital, and woudl most likely be suspicious of the offending facility. It would behoove you to explain in detail how the patient came to leave the other guys hospital, and come to them. > > Just to try to prevent some " what if " issues, the patient is in no > apparent distress, just a twisted ankle with stable vitals that is > not being seen fast enough or getting the attention he feels he > needs. I'm not advocating abandoning the patient where he is. I do > recognize the need to bring him to the attention of the ED or > whatever response team the hospital has for on-campus emergencies, > and would activate that team or contact them somehow. The what if's are the best ones, better to deal with a 'what if' then an 'Oh sh**, what now?' Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2004 Report Share Posted June 1, 2004 Another thought about this: A few years ago while we were still hospital based, I posed the question to to the folks that are in the know and regulate the EMTALA investigations about utilizing the hospitals pad to fly out a trauma patient. I was told then that you must always be able to demonstrate that you are acting in good faith and do what is right for the patient. They stated that if a complaint were filed that I would have to explain why putting the patient on the helicopter was more beneficial for the patient than going into the E.R.. Nothing like getting a straight answer huh? Then and now I feel that I would put the patient on the bird if that was what was best for the patient. We talk a lot about getting patients to trauma centers quickly. I pose this question to you all. How many times have you taken a patient to a Level IV for stabilization and watched the clock tick away while other hospitals get their billing information straight prior to accepting? The nurse spends more time talking to the business office than it takes to give a report to the receiving hospital. Usually, it takes several calls and return calls before the patient is accepted. Example: Not saying this happened, butttttt is a good example. A helicopter crew is having a meet and greet with the E.R. staff when a patient presents with a MI at the E.R. Within minutes a clot buster med is on board and the patients cardiologist in a city 130 miles away is notified, not saying this city is Houston. The Doc say ship right away, do you have a helicopter available, what you have one on the pad right now, great git the patient on the way. Over an hour later the patient is flown 30 miles down the road because the hospital in the distant city refused the patient. The patient had to see another Doc. Did I fail to mention why the patient did not go by ground to the hospital just down the road. It seem that the Hous...... whoops the hospital 130 miles down the road had accepted at first. The patient was place on the helicopter stretcher and care turned over to the flight crew with med administered by the crew. Just as they were walking out the door the hospital called back and said they could not take the patient. I have used this factious example to stimulate some pitter patter for the list serve Henry Henry Barber wrote: > If the patient has signed himself \ her and for whatever reason does not > want to be treated at that facility, you would fall under the same > guidelines if a patient at Wal Mart ask you to transport him\her. The > hospital may have to document and explain why and how the this occurred. If > the hospital was trying to take care of the patient and the patient decided > he\she wanted to go to another location, I do not see this as a EMTALA > violation. The next receiving hospital may squawk a little. However, if I > were the medic making the call, I would make sure to explain the details > regarding the original hospital attempting to assist this patient and that > the move was the patients choice. If you are a hospital based Service and > the first hospital is your base, you may have issues with your superiors if > you transport. I would expect the issues would be that the hospital does > not want to be placed in a position of even looking like a EMTALA > violation. > > Henry > > bearamedic99 wrote: > > > A coworker & I were debating this after she was approached in an ER > > last shift. > > > > What is the proper thing to do if someone on a hospital campus > > either calls 911 or walks up to you, and requests transport to > > another facility? > > > > I believe that once on the hospital grounds, they are under the > > responsibility of that facility and must go through the facility's > > administration for transfer. Am I right? > > > > Does it matter whether the patient is in the ER waiting room, in > > the parking lot, or in the housekeeping shed separate from other > > buildings? Does it matter if the patient has already been triaged, > > not been triaged yet, or is leaving AMA (though still on the > > property)? > > > > Just to try to prevent some " what if " issues, the patient is in no > > apparent distress, just a twisted ankle with stable vitals that is > > not being seen fast enough or getting the attention he feels he > > needs. I'm not advocating abandoning the patient where he is. I do > > recognize the need to bring him to the attention of the ED or > > whatever response team the hospital has for on-campus emergencies, > > and would activate that team or contact them somehow. > > > > I'd appreciate your input, especially if you have JD after your > > name or work for TDH. > > > > Thank you, > > > > Andy Wheeler > > > > PS- Does the state conference ever offer CEs on legal issues or > > classes on Medicare/Medicaid reimbursements? > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2004 Report Share Posted June 1, 2004 Another thought about this: A few years ago while we were still hospital based, I posed the question to to the folks that are in the know and regulate the EMTALA investigations about utilizing the hospitals pad to fly out a trauma patient. I was told then that you must always be able to demonstrate that you are acting in good faith and do what is right for the patient. They stated that if a complaint were filed that I would have to explain why putting the patient on the helicopter was more beneficial for the patient than going into the E.R.. Nothing like getting a straight answer huh? Then and now I feel that I would put the patient on the bird if that was what was best for the patient. We talk a lot about getting patients to trauma centers quickly. I pose this question to you all. How many times have you taken a patient to a Level IV for stabilization and watched the clock tick away while other hospitals get their billing information straight prior to accepting? The nurse spends more time talking to the business office than it takes to give a report to the receiving hospital. Usually, it takes several calls and return calls before the patient is accepted. Example: Not saying this happened, butttttt is a good example. A helicopter crew is having a meet and greet with the E.R. staff when a patient presents with a MI at the E.R. Within minutes a clot buster med is on board and the patients cardiologist in a city 130 miles away is notified, not saying this city is Houston. The Doc say ship right away, do you have a helicopter available, what you have one on the pad right now, great git the patient on the way. Over an hour later the patient is flown 30 miles down the road because the hospital in the distant city refused the patient. The patient had to see another Doc. Did I fail to mention why the patient did not go by ground to the hospital just down the road. It seem that the Hous...... whoops the hospital 130 miles down the road had accepted at first. The patient was place on the helicopter stretcher and care turned over to the flight crew with med administered by the crew. Just as they were walking out the door the hospital called back and said they could not take the patient. I have used this factious example to stimulate some pitter patter for the list serve Henry Henry Barber wrote: > If the patient has signed himself \ her and for whatever reason does not > want to be treated at that facility, you would fall under the same > guidelines if a patient at Wal Mart ask you to transport him\her. The > hospital may have to document and explain why and how the this occurred. If > the hospital was trying to take care of the patient and the patient decided > he\she wanted to go to another location, I do not see this as a EMTALA > violation. The next receiving hospital may squawk a little. However, if I > were the medic making the call, I would make sure to explain the details > regarding the original hospital attempting to assist this patient and that > the move was the patients choice. If you are a hospital based Service and > the first hospital is your base, you may have issues with your superiors if > you transport. I would expect the issues would be that the hospital does > not want to be placed in a position of even looking like a EMTALA > violation. > > Henry > > bearamedic99 wrote: > > > A coworker & I were debating this after she was approached in an ER > > last shift. > > > > What is the proper thing to do if someone on a hospital campus > > either calls 911 or walks up to you, and requests transport to > > another facility? > > > > I believe that once on the hospital grounds, they are under the > > responsibility of that facility and must go through the facility's > > administration for transfer. Am I right? > > > > Does it matter whether the patient is in the ER waiting room, in > > the parking lot, or in the housekeeping shed separate from other > > buildings? Does it matter if the patient has already been triaged, > > not been triaged yet, or is leaving AMA (though still on the > > property)? > > > > Just to try to prevent some " what if " issues, the patient is in no > > apparent distress, just a twisted ankle with stable vitals that is > > not being seen fast enough or getting the attention he feels he > > needs. I'm not advocating abandoning the patient where he is. I do > > recognize the need to bring him to the attention of the ED or > > whatever response team the hospital has for on-campus emergencies, > > and would activate that team or contact them somehow. > > > > I'd appreciate your input, especially if you have JD after your > > name or work for TDH. > > > > Thank you, > > > > Andy Wheeler > > > > PS- Does the state conference ever offer CEs on legal issues or > > classes on Medicare/Medicaid reimbursements? > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2004 Report Share Posted June 1, 2004 Another thought about this: A few years ago while we were still hospital based, I posed the question to to the folks that are in the know and regulate the EMTALA investigations about utilizing the hospitals pad to fly out a trauma patient. I was told then that you must always be able to demonstrate that you are acting in good faith and do what is right for the patient. They stated that if a complaint were filed that I would have to explain why putting the patient on the helicopter was more beneficial for the patient than going into the E.R.. Nothing like getting a straight answer huh? Then and now I feel that I would put the patient on the bird if that was what was best for the patient. We talk a lot about getting patients to trauma centers quickly. I pose this question to you all. How many times have you taken a patient to a Level IV for stabilization and watched the clock tick away while other hospitals get their billing information straight prior to accepting? The nurse spends more time talking to the business office than it takes to give a report to the receiving hospital. Usually, it takes several calls and return calls before the patient is accepted. Example: Not saying this happened, butttttt is a good example. A helicopter crew is having a meet and greet with the E.R. staff when a patient presents with a MI at the E.R. Within minutes a clot buster med is on board and the patients cardiologist in a city 130 miles away is notified, not saying this city is Houston. The Doc say ship right away, do you have a helicopter available, what you have one on the pad right now, great git the patient on the way. Over an hour later the patient is flown 30 miles down the road because the hospital in the distant city refused the patient. The patient had to see another Doc. Did I fail to mention why the patient did not go by ground to the hospital just down the road. It seem that the Hous...... whoops the hospital 130 miles down the road had accepted at first. The patient was place on the helicopter stretcher and care turned over to the flight crew with med administered by the crew. Just as they were walking out the door the hospital called back and said they could not take the patient. I have used this factious example to stimulate some pitter patter for the list serve Henry Henry Barber wrote: > If the patient has signed himself \ her and for whatever reason does not > want to be treated at that facility, you would fall under the same > guidelines if a patient at Wal Mart ask you to transport him\her. The > hospital may have to document and explain why and how the this occurred. If > the hospital was trying to take care of the patient and the patient decided > he\she wanted to go to another location, I do not see this as a EMTALA > violation. The next receiving hospital may squawk a little. However, if I > were the medic making the call, I would make sure to explain the details > regarding the original hospital attempting to assist this patient and that > the move was the patients choice. If you are a hospital based Service and > the first hospital is your base, you may have issues with your superiors if > you transport. I would expect the issues would be that the hospital does > not want to be placed in a position of even looking like a EMTALA > violation. > > Henry > > bearamedic99 wrote: > > > A coworker & I were debating this after she was approached in an ER > > last shift. > > > > What is the proper thing to do if someone on a hospital campus > > either calls 911 or walks up to you, and requests transport to > > another facility? > > > > I believe that once on the hospital grounds, they are under the > > responsibility of that facility and must go through the facility's > > administration for transfer. Am I right? > > > > Does it matter whether the patient is in the ER waiting room, in > > the parking lot, or in the housekeeping shed separate from other > > buildings? Does it matter if the patient has already been triaged, > > not been triaged yet, or is leaving AMA (though still on the > > property)? > > > > Just to try to prevent some " what if " issues, the patient is in no > > apparent distress, just a twisted ankle with stable vitals that is > > not being seen fast enough or getting the attention he feels he > > needs. I'm not advocating abandoning the patient where he is. I do > > recognize the need to bring him to the attention of the ED or > > whatever response team the hospital has for on-campus emergencies, > > and would activate that team or contact them somehow. > > > > I'd appreciate your input, especially if you have JD after your > > name or work for TDH. > > > > Thank you, > > > > Andy Wheeler > > > > PS- Does the state conference ever offer CEs on legal issues or > > classes on Medicare/Medicaid reimbursements? > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2004 Report Share Posted June 1, 2004 In a message dated 6/1/2004 10:43:44 AM Central Standard Time, bearamedic99@... writes: A coworker & I were debating this after she was approached in an ER last shift. What is the proper thing to do if someone on a hospital campus either calls 911 or walks up to you, and requests transport to another facility? We shoot them then take them back inside for further treatment. JUST KIDDING. Andy Foote Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2004 Report Share Posted June 1, 2004 In a message dated 6/1/2004 10:43:44 AM Central Standard Time, bearamedic99@... writes: A coworker & I were debating this after she was approached in an ER last shift. What is the proper thing to do if someone on a hospital campus either calls 911 or walks up to you, and requests transport to another facility? We shoot them then take them back inside for further treatment. JUST KIDDING. Andy Foote Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2004 Report Share Posted June 1, 2004 In a message dated 6/1/2004 10:43:44 AM Central Standard Time, bearamedic99@... writes: A coworker & I were debating this after she was approached in an ER last shift. What is the proper thing to do if someone on a hospital campus either calls 911 or walks up to you, and requests transport to another facility? We shoot them then take them back inside for further treatment. JUST KIDDING. Andy Foote Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2004 Report Share Posted June 1, 2004 I think as long as you don't p/u from the ER room that you should be ok. I have made MVA's in the parking lots of the hospital and transported across town and not a word was ever asked. Its all patient preference and nessessity. Jeff EMT-I Houston,Tx > I think your closing remarks were right on the money. Keep everyone in the > loop. > > > 'Tater Salad' Hatfield EMT-P > > " Caesar si viveret, ad remum dareris " > > Start getting ready now!!! EMStock 2005!! > www.EMStock.com > www.temsf.org > > > From: " bearamedic99 " <bearamedic99@y...> > > > > What is the proper thing to do if someone on a hospital campus > > either calls 911 or walks up to you, and requests transport to > > another facility? > > That would much depend upon you services' SOP's. It's not an EMTALA issue > unless the hospital has refused to see the patient etc. If the hospital has > already triaged the patient, and no life threatening injuries or illnesses > present, than to a certain degree, the hospital has fulfilled it's duties. > If the aptient is pissed cause they don't want to wait, that's another > story. There is nothign you can do to 'require' the patient to go back to > the facility if they don' want to. > > > > > I believe that once on the hospital grounds, they are under the > > responsibility of that facility and must go through the facility's > > administration for transfer. Am I right? > > EMTALA states that once they are on hospital grounds, regardless of where > they are on the grounds, housekeeping shed seperate from the building etc., > the hospital is responsible from an EMTALA point of view. In order for it to > be a interfacility transfer, then yes, you would have to go through the > administration, get a receiving facility, and docor, and all the other stuff > you have to do. > > The patient has the right to leave, signed paperwork or not for AMA, I have > worked in bigger city ER's where seom just get up go outside to smoke, and > never return. In Fayetteville, I got a 911 call from the payphone in an ER > waiting room. > > > > > Does it matter whether the patient is in the ER waiting room, in > > the parking lot, or in the housekeeping shed separate from other > > buildings? Does it matter if the patient has already been triaged, > > not been triaged yet, or is leaving AMA (though still on the > > property)? > > It only matters to the hospital whose grounds they are on. For example, > employee A gets injured on the grounds, and although they are an employee of > the hospital, they choose to go to another facility, call 911, and tell you > that they want to go to the hospital on the other side of town. The hospital > would most likely wnat to cover their a**, and understandably so. The > receiving facility will be irked as the patient was already at a hospital, > and woudl most likely be suspicious of the offending facility. It would > behoove you to explain in detail how the patient came to leave the other > guys hospital, and come to them. > > > > > Just to try to prevent some " what if " issues, the patient is in no > > apparent distress, just a twisted ankle with stable vitals that is > > not being seen fast enough or getting the attention he feels he > > needs. I'm not advocating abandoning the patient where he is. I do > > recognize the need to bring him to the attention of the ED or > > whatever response team the hospital has for on-campus emergencies, > > and would activate that team or contact them somehow. > > The what if's are the best ones, better to deal with a 'what if' then an 'Oh > sh**, what now?' Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2004 Report Share Posted June 1, 2004 I think as long as you don't p/u from the ER room that you should be ok. I have made MVA's in the parking lots of the hospital and transported across town and not a word was ever asked. Its all patient preference and nessessity. Jeff EMT-I Houston,Tx > I think your closing remarks were right on the money. Keep everyone in the > loop. > > > 'Tater Salad' Hatfield EMT-P > > " Caesar si viveret, ad remum dareris " > > Start getting ready now!!! EMStock 2005!! > www.EMStock.com > www.temsf.org > > > From: " bearamedic99 " <bearamedic99@y...> > > > > What is the proper thing to do if someone on a hospital campus > > either calls 911 or walks up to you, and requests transport to > > another facility? > > That would much depend upon you services' SOP's. It's not an EMTALA issue > unless the hospital has refused to see the patient etc. If the hospital has > already triaged the patient, and no life threatening injuries or illnesses > present, than to a certain degree, the hospital has fulfilled it's duties. > If the aptient is pissed cause they don't want to wait, that's another > story. There is nothign you can do to 'require' the patient to go back to > the facility if they don' want to. > > > > > I believe that once on the hospital grounds, they are under the > > responsibility of that facility and must go through the facility's > > administration for transfer. Am I right? > > EMTALA states that once they are on hospital grounds, regardless of where > they are on the grounds, housekeeping shed seperate from the building etc., > the hospital is responsible from an EMTALA point of view. In order for it to > be a interfacility transfer, then yes, you would have to go through the > administration, get a receiving facility, and docor, and all the other stuff > you have to do. > > The patient has the right to leave, signed paperwork or not for AMA, I have > worked in bigger city ER's where seom just get up go outside to smoke, and > never return. In Fayetteville, I got a 911 call from the payphone in an ER > waiting room. > > > > > Does it matter whether the patient is in the ER waiting room, in > > the parking lot, or in the housekeeping shed separate from other > > buildings? Does it matter if the patient has already been triaged, > > not been triaged yet, or is leaving AMA (though still on the > > property)? > > It only matters to the hospital whose grounds they are on. For example, > employee A gets injured on the grounds, and although they are an employee of > the hospital, they choose to go to another facility, call 911, and tell you > that they want to go to the hospital on the other side of town. The hospital > would most likely wnat to cover their a**, and understandably so. The > receiving facility will be irked as the patient was already at a hospital, > and woudl most likely be suspicious of the offending facility. It would > behoove you to explain in detail how the patient came to leave the other > guys hospital, and come to them. > > > > > Just to try to prevent some " what if " issues, the patient is in no > > apparent distress, just a twisted ankle with stable vitals that is > > not being seen fast enough or getting the attention he feels he > > needs. I'm not advocating abandoning the patient where he is. I do > > recognize the need to bring him to the attention of the ED or > > whatever response team the hospital has for on-campus emergencies, > > and would activate that team or contact them somehow. > > The what if's are the best ones, better to deal with a 'what if' then an 'Oh > sh**, what now?' Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2004 Report Share Posted June 1, 2004 I think as long as you don't p/u from the ER room that you should be ok. I have made MVA's in the parking lots of the hospital and transported across town and not a word was ever asked. Its all patient preference and nessessity. Jeff EMT-I Houston,Tx > I think your closing remarks were right on the money. Keep everyone in the > loop. > > > 'Tater Salad' Hatfield EMT-P > > " Caesar si viveret, ad remum dareris " > > Start getting ready now!!! EMStock 2005!! > www.EMStock.com > www.temsf.org > > > From: " bearamedic99 " <bearamedic99@y...> > > > > What is the proper thing to do if someone on a hospital campus > > either calls 911 or walks up to you, and requests transport to > > another facility? > > That would much depend upon you services' SOP's. It's not an EMTALA issue > unless the hospital has refused to see the patient etc. If the hospital has > already triaged the patient, and no life threatening injuries or illnesses > present, than to a certain degree, the hospital has fulfilled it's duties. > If the aptient is pissed cause they don't want to wait, that's another > story. There is nothign you can do to 'require' the patient to go back to > the facility if they don' want to. > > > > > I believe that once on the hospital grounds, they are under the > > responsibility of that facility and must go through the facility's > > administration for transfer. Am I right? > > EMTALA states that once they are on hospital grounds, regardless of where > they are on the grounds, housekeeping shed seperate from the building etc., > the hospital is responsible from an EMTALA point of view. In order for it to > be a interfacility transfer, then yes, you would have to go through the > administration, get a receiving facility, and docor, and all the other stuff > you have to do. > > The patient has the right to leave, signed paperwork or not for AMA, I have > worked in bigger city ER's where seom just get up go outside to smoke, and > never return. In Fayetteville, I got a 911 call from the payphone in an ER > waiting room. > > > > > Does it matter whether the patient is in the ER waiting room, in > > the parking lot, or in the housekeeping shed separate from other > > buildings? Does it matter if the patient has already been triaged, > > not been triaged yet, or is leaving AMA (though still on the > > property)? > > It only matters to the hospital whose grounds they are on. For example, > employee A gets injured on the grounds, and although they are an employee of > the hospital, they choose to go to another facility, call 911, and tell you > that they want to go to the hospital on the other side of town. The hospital > would most likely wnat to cover their a**, and understandably so. The > receiving facility will be irked as the patient was already at a hospital, > and woudl most likely be suspicious of the offending facility. It would > behoove you to explain in detail how the patient came to leave the other > guys hospital, and come to them. > > > > > Just to try to prevent some " what if " issues, the patient is in no > > apparent distress, just a twisted ankle with stable vitals that is > > not being seen fast enough or getting the attention he feels he > > needs. I'm not advocating abandoning the patient where he is. I do > > recognize the need to bring him to the attention of the ED or > > whatever response team the hospital has for on-campus emergencies, > > and would activate that team or contact them somehow. > > The what if's are the best ones, better to deal with a 'what if' then an 'Oh > sh**, what now?' Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2004 Report Share Posted June 1, 2004 Watch out! Your true personality is showing! Maxine Pate ----- Original Message ----- We shoot them then take them back inside for further treatment. JUST KIDDING. Andy Foote Quote Link to comment Share on other sites More sharing options...
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