EMS - EC handoffs - ER Hallway patients.

[Bryan Boling]

I used to work in an ED where we sent ambulance patients to the Waiting Room
on a regular basis.  EMS would show up, the charge nurse would do a triage
and start a chart and if they were truly non-emergent, they were sent to the
waiting room.  Before we started doing that, people would call 911 routinely
because they knew that by coming in on an Ambulance, they got to bypass
triage and wouldn't have to wait to be seen.  After we started "triaging to
the lobby" the local FD reported a sharp decrease in the amount of
non-emergency calls.  (We were the only "county" facility in the region so
almost all of those types of calls ended up in our ED versus the private
hospitals...)

I don't see a problem with that as long as they were screened by a nurse
just as they would have been if they'd walked in...


On 3/3/07, KMATTOX at aol.com <KMATTOX at aol.com> wrote:
>
>
> In a message dated 3/2/2007 2:17:34 P.M. Central Standard Time,
> ben.addleman at gmail.com writes:
>
> EMS  should be
> permitted to leave stable patients in the ER waiting room rather  than
> having
> to remain with them until an ER bed is available for them,  as
>
>
> This is NOT an EMS issue.  It is a hospital, medical staff, and  Emergency
> Center issue.    The time of EMS to EC handoff should  be no more than 5
> minutes
> so EMS can complete their paperwork and get back into  service to the
> community.
>
> For a patient to already be inside the hospital or ER walls (? even on the
> hospital property), that patient is under the moral, ethical, medical, and
> legal  responsibility of the hospital and its medical staff.  Just because
> there
> is a delay in handoff to ER personnel, and the patient is still on the
> ambulance  gurney with an EMT or Paramedic does not relieve the hospital
> and its
> medical  staff of their EMTALA, and other medical evaluation and treatment
> responsibilities.
>
> I recognize the EC is overcrowded, often with non -  emergencies.    That
> is
> a policy and societal problem with which  we MUST grapple.  I recognize
> that
> persons call the ambulance and EMS  to expedite getting into the ER, but
> society (consumerism) has assumed that if  one arrives by ambulance to an
> ER, the
> patient will be seen, triaged, and cared  for expediciously (? 5 minutes
> or
> less).   That assumption becomes a  duty when it gets into a court room,
> especially if a BAD outcome happened after  arrival at the hospital and
> before the
> hospital and its medical staff assumed  care.
>
>
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