Re: stable neonate transports

["Wesley Copeland Sr., MICT, NREMT-P, CCEMTP" <wcemt@terraworld.net>]

I hate to even reply to this as it will surely open a can of worms but I
can't resist.

I must agree with Jeff.  As a Paramedic in Kansas I have taken ground
transfers where the patients have had multiple drips going and I was giving
Retavase and other meds enroute.  I took these patients from an ER or ICU
with Doctors and Nurses and put them in the back of my truck for a 2 hour
ride by ground with only me in the back.  Did I violate EMTALA by not taking
a Dr. or RN?!?  The answer is a big NO.  I continued the level of care being
offered at the sending facility therefore there was no EMTALA violation.

Level of care is defined by the treatments, procedures and medications
available through your protocols, not by what initials you may or may not
have behind you name.  Given you must have the training and credentials to
legally utilize the protocols, but lets look at the bigger picture.  I doubt
anyone on this list would say a dermatologist is appropriate to manage a
critical cardiac or trauma patient during a transfer but they have "MD"
behind their names and are Doctors.  Would sending a Dermatologist with a
critical cardiac patient be an EMTALA violation?  According to those who say
EMTALA refers to "titles", this would be perfectly appropriate because this
person is a Doctor.  However who really thinks this argument would hold up
in court.

Just my 2 cents worth.

Wesley Copeland




----- Original Message -----
From: "Jeff Brosius" <reno316@hotmail.com>
To: <flightmed@flightweb.com>
Sent: Saturday, March 30, 2002 1:31 PM
Subject: Re: stable neonate transports


>
> >The way this was explained to me by our Hospital's legal people is that
> >when
> >a patient is retrieved from another facility using a hospital-based
> >transport
> >service, whether it be ground or air, it is an EMTALA violation to
provide
> >a
> >level of care less than what the patient was receiving at the sending
> >hospital, or will receive at the receiving hospital.
>
>
> I certainly hope this is not the case.  I've taken many many patients from
> one ICU to another and not had an RN along.  Now while it is possible that
> the 'level of care' referrs only to the meds/interventions available and
not
> the education/training level (i.e. as long as the medic can monitor the
> Nitro, Heparin, and Aggrastat drips, keep the EKG monitor going, and etc.)
> then there is no EMTALA violation.  However, if the 'level of care'
> requirement implies that education/training level must also be the same,
> then I've been party to more violations than I can remember.
>
> For services taking a patinet from one ER to another...  You'd fall into
> this as well, wouldn't you?
>
> Check out  http://www.medlaw.com  for a good resource.
>
>
> ------------
> JRB
>
> Jeff Brosius,
> Paramedic, etc.
> Atlanta, GA
> www.prehospital-perspective.com
> LET'S GO HOOSIERS!!!!!!!!!!!!!!
>
>
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