r/Paramedics • u/Dowcastle-medic Paramedic • Jun 25 '25

US EMTALA and bypassing a hospital

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?

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u/Dowcastle-medic Paramedic Jun 25 '25

That’s what I thought.

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u/PerrinAyybara Captain CQI Narc Jun 25 '25

That's the only answer you need if you aren't hospital based. The better question is why does the ER doc matter? What did your OMD and supervision say?

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u/Dowcastle-medic Paramedic Jun 25 '25

Our online medical control is the ER Dr I can choose which hospital to call for that though…

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u/PerrinAyybara Captain CQI Narc Jun 26 '25

Wait, your state doesn't have a medical director for each agency?

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u/Dowcastle-medic Paramedic Jun 26 '25

My medical director is an ER Dr who lives 9 hours away and is the medical director for probably 20 different agencies. He’s a great guy but very busy. And will answer my questions but not necessarily while I am on a call.