EMTALA and bypassing a hospital

[u/Dowcastle-medic]

So I had a pt today totally stable but she has an injury I know the local type 4 community hospital (20min) is not going to be able to fix. It was suggested by the clinic staff where I picked her up to go to the type 3, 1.5 hours away. But one of the ER drs for the community hospital happened to be there and looked at the injury and said no just take her to our hospital.

She said the type 3 couldn’t deal with that either and she would need to go to One 3.5 hours away so go and get her c spine cleared…

So we did and then I get chewed out by the ER drs on call saying I can NEVER bypass them based on EMTALA. I always have to stop and let them stabilize the pt and cat scan and such…

That’s not true is it?

[u/Immediate-Coconut700]

I came here to ask a similar question to y’all today just on the opposite side of things. Urgent care clinic thinks patient who is asymptomatic and feels totally fine — who just happened to take her BP today — needs to go to high acuity ED an hour away because her cardiologist “is there.” Recently taken off BP meds. Does have cardiac history but nothing suggesting anything happening right now aside from needing to be back on BP meds. Thought it was definitely good to go to ED based on history, but no need to go to an hour away and wait for six hours. Apparently clinic had to redo the EMTALA and was angry I even did an assessment because I was delaying care? What the hell

[u/emergentologist → u/Immediate-Coconut700]

Thought it was definitely good to go to ED based on history

Nah, that patient doesn't even need to go to the ED based on the scenario given. Absolutely ridiculous of the quick care staff to not only send them to the ED, not only by ambulance, but also wanting to send them an hour away. Fucking hell what an epic waste of a lot of resources.

[u/Immediate-Coconut700 → u/emergentologist]

I appreciate you! I actually had to look at this twice to make sure it wasn’t my own comment because it sounds like me so much 😂