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Case 1
answer
What arrangements are necessary to transfer the child to a
facility 45 miles away, where plastic surgery consultation is
available?
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(Incorrect) Once medical stabilization is
complete then the child may be transferred by EMS to a facility
less than 1 hour away.
Several conditions must be met before the child can be
transferred.
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The child must be stabilized.
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The receiving facility must be notified, and
willing to accept the child.
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All appropriate medical records must accompany
the child, and appropriate transportation must be arranged. In
some cases transportation might involve sending medical
personnel with the child or arranging specialized transfer,
such as a Neonatal Transport service.
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Pros and cons of transportation should be
discussed with the parents. You should inform them that
adequate general surgery services are available in your
facility, but for the sake of the child the outcome may be
improved with the services of a specialist.
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(Incorrect) Your medical screening exam is
complete and the patient has been stabilized. You may now
investigate the insurance status of the patient and transfer to
a nearby facility if their insurance authorizes the transfer.
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Management decisions should be made in the
best interest of the patient, not by insurance status.
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Receiving facilities must accept and treat the
patient if they have space and qualified personnel.
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(Correct)
You must contact the nearby facility and have them accept
your patient before you can transfer.
Several conditions must be met before the child can be
transferred.
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Medical stabilization.
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Acceptance of the transfer by the receiving
facility.
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All appropriate medical records must accompany
the child.
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Appropriate transportation must be arranged.
In some cases this might involve sending medical personnel
with the child, or arranging specialized transportation such
as Neonatal Transport Services.
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You will also have a responsibility of
discussing with the parents the pros and cons of transferring
the child. Inform them that adequate general surgery services
are available in your facility, but the outcome may be
improved with the services of a specialist.
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(Incorrect) You can discharge your patient
from your emergency department and instruct the parents to take
the child to a nearby facility where EMTALA regulations will
guarantee that the child will receive services.
This is a flagrant violation of EMTALA regulations.
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The receiving facility has not been informed,
or accepted the child to their facilities.
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You have not made arrangements for medical
records.
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You have not arranged appropriate
transportation for the child who may have other injuries
besides those you have stabilized.
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