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?
2
u/Difficult_Sweet_6904 Jun 26 '25
EMTALA starts at hospital property. Not in the ambulance. You go to the closest most appropriate facility. Or if patient is requesting bypassing the closest most appropriate facility, you make sure they have decisional making capacity and get informed consent and a signature. 99% of ER docs have no clue about anything EMS unless they used to be in it, or are a medical director tor EMS.