Dispatched to the ER Waiting Room?

[Riblett]

If I go to the ER with an emergency and I am not being scene, I will make sure I get care I need by whatever means possible, even if that is calling for an ambulance. I do not care if I am in a hospital. I am sitting there not being taken care of. I will call someone who will take care of me.

And does you opinion change based on the level of your emergency? I mean, toe pain versus crushing chest pain for example.

[crotchitymedic1986]

Riblett, this has nothing to do with EMTALA. EMTALA is a law that guarantees any patient "a proper screening exam" regardless of ability to pay. This patient had been screened, there was no issue regarding paymnet per the OP. This was about a mom who felt that her child was not being cared for fast enough or well enough. It does not matter where the patient is, if the patient were in a Pediatrician's Office, would you refuse to transport ? No, because while the Doctor's office is care, it is not the definitive care the patient needs. Although this was an ER by name, it sounds like one of those rural facilities (probably a nursing home, with an ER attached) where very little real care can be provided. A pediatric patient with a respiratory condition of any kind probably needed to be somewhere else.

[FireMedic65]

And does you opinion change based on the level of your emergency? I mean, toe pain versus crushing chest pain for example.

Yes, of course it does. I HAVE been in these situations. If they are in he waiting room, they are NOT in care of any higher level of care. If I am called to help, I will help. If the patient is in the waiting room with chest pains they are not being scene is gross negligence of the ER. Regardless of how you feel the importance of a persons emergency is, it IS one to them. Our job is to help them when they are in need. If I am asked to go to the ER for a patient I will go. Would I take them to another hospital for care? Well, that depends.

[crotchitymedic1986]

To some extent he is right. If your automechanic saw huge increases in customers between the hours of 3p-5p, he would probably add some mechanics or expand hours. But in the ER, this never happens. Whereelse do you wait 5-6 hours for service ? In any other business this is unacceptable, but hospital CEOs do not care.

[Riblett]

Crochity, I am the OP. And that was not the case.

[crotchitymedic1986]

I am sorry then, I missed the part where you described that this patient was not being seen due to inability to pay.

[AnthonyM83]

I don't want to say this occurs regularly around here...but it's definitely not rare.

Often, we just follow our transport to closest hospital policy, by wheeling them out of the waiting room, through the ambulance parking lot, up the ambulance ramp, back in the ER, have the nurse direct us out to the waiting room, then drop the patient back into the same chair, and just make sure the nurse signs off for us.

Though, other times it does work and they get a bed immediately.

[Riblett]

Crochity, I am not saying that payment was an issue in this case. I was saying that your description of the ER was not accurate. They are more than capable of treating pediatric patients, and do so quite often. What they lack is the ability to admit those requiring ICU care.

I think that this case has everything to do with EMTALA. Its sole purpose is to ensure equal care for all and prevent hospitals from transferring patients inappropriately. If we routinely circumvent it by transferring patients from the waiting room that have not been screened, stabilized, and certified for transport we open ourselves up to huge liability. If we take part in these transfers, what is to stop them from being performed in the future based on a persons ability to pay, etc? As I said, if the hospitals know we'll bypass the laws and just transfer them then why not just leave the ones they don't want to treat in the waiting room?

[NYCEMS9115]

If I go to the ER with an emergency and I am not being scene, I will make sure I get care I need by whatever means possible, even if that is calling for an ambulance. I do not care if I am in a hospital. I am sitting there not being taken care of. I will call someone who will take care of me.

What care are you talking about. Definitive care? EMS doesn't provide that kind of care.

[crotchitymedic1986]

First of all this is not a frequent call, I doubt it happens more than 2 times per month in any county, the fact that you are just now bringing it up, shows how often in happens in your neck of the woods. Would you consider this an EMTALA problem if the patient called a cab ? A patient calling from the ER (or any other part of the hospital) for an ambulance transfer to a hospital they prefer for whatever reason does not constitute an EMTALA violation for EMS (unless the ambulance service is hospital owned).