trauma response within the hospital

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I wasn't aware of any claim that EMTALA has any effect on by-passing
hospitals, only on turning patients away from hospitals once the
patients are withing however many yards of the hospital entrance. If the
patient is already on the hospital grounds, as appears to be the case in
this topic of discussion, doesn't EMTALA still apply? I am not
suggesting that this is the best way to handle things and can give
examples of patients endangered by this interpretation, but that is the
way the doctors tell us to act.

Even if the local protocols allowed EMS to transport patients off of the
hospital grounds to the trauma center, which may be better for patients,
how would that be interpreted as excusing the hospital from any
responsibility for a person, who appears to be a patient, on the
hospital grounds?

If the hospital is a trauma center, would there be any reason to allow
the patient to by-pass the hospital to get to a trauma center? There are
almost regular drop-offs of patients in the parking lot of trauma
centers. How does a trauma center justify leaving the patient in the
parking lot in if EMS is not already there? If there is concern about
the safety of hospital personnel, waiting for armed security/police is
reasonable, should be expected, and is justification for having armed
security and/or police on the premises.

Trauma center staff/ED staff should be capable of moving a patient from
the ground to a long board without increasing the patient's injuries.
Immobilization is part of ATLS. 

Are techs working in the trauma center required to have any EMS
certification as a job requirement.

Tim Noonan.

On Sun, 02 Aug 2009 21:10 -0500, "McSwain, Norman E Jr."
<nmcswai at tulane.edu> wrote:
> Local protocols can override the EMTALA rules if they are equally
> enforced through the area and well accepted. i.e. EMS units bypassing
> local hospitals and going directly to the trauma center per protocol
>  
> Norman
>  
> Norman McSwain MD
> Trauma Director, Charity Hospital
> Professor of Surgery, Tulane University
> New Orleans LA
> 504 988 5111
> norman.mcswain at tulane.edu <mailto:norman.mcswain at tulane.edu> 
> 
> ________________________________
> 
> From: trauma-list-bounces at trauma.org on behalf of Steven P. Rogers, RN
> Sent: Sun 8/2/2009 7:05 PM
> To: 'Trauma-List [TRAUMA.ORG]'
> Subject: RE: trauma response within the hospital
> 
> 
> By EMTALA standards aren't you responsible for all patients in and around
> your hospital, I seem to recall the figure of 200 yards. 
> 
> ________________________________

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