EMTALA Q&A
Question: Suppose there is an off-site accident, and the patient needs to be life-flighted to a tertiary care center, but the helicopter cannot land at the site. If that patient is transported by emergency medical services to the helicopter site on our campus, does the patient need to be registered in our emergency department and seen by our ED physicians? Or can the patient be taken directly to the helicopter and flown to a tertiary care center?
Answer: The general rule is that if the helipad is being used for the sole purpose of transferring a patient between a ground ambulance and a helicopter, then EMTALA screening and stabilization requirements do not apply, says John D. Lipson, MD, MBA, principal of Columbus, IN-based Medical Staff Support Services, which assists medical staff leaders and administrators with EMTALA compliance.
However, if the ambulance or helicopter crew asked for hospital assistance with patient evaluation, stabilization, or management, then EMTALA does apply, Lipson adds. This would include creating a medical record, providing a medical screening examination by a physician, and providing stabilization treatment, he says.
The other exception to the "bypass" rule is when the ambulance is hospital-owned and not acting as part of a communitywide emergency medical services protocol, Lipson adds. "EMTALA requirements would apply in this case," he says.
Lipson recommends that if the helipad is being used for this transfer purpose, a hospital administrative person (such as the nursing supervisor or other clinical manager), meet the unit on the pad to ascertain if hospital assistance is needed. The incident should be documented in the administrative log in case any questions arise in the future, he says.
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