Emergency Departments Calling Ambulances for Emergencies
I'm on vacation this week, which means that I don't have any observations to report from the ambulance. In the meantime, an anonymous reader has suggested a topic of discussion. According to a story in the Vancouver Sun, the emergency department staff at a Vancouver hospital refused to assist a man who'd collapsed just ten feet outside the emergency department's doors. Instead, they called for an ambulance.
In the United States, this incident would have fallen within the scope of a federal law, the Emergency Medical Treatment and Active Labor Act (EMTALA). Among other things, this law requires hospitals with emergency departments to screen and stabilize patients who come to their facilities seeking help for medical conditions. Under EMTALA, a patient "comes to" an emergency department once he gets within 250 yards of it, even if he doesn't explicitly request assistance. As long as the patient appears to need treatment, the emergency department must respond.
I don't know much about Canadian health care law. I don't know whether that country has any statutes equivalent to EMTALA. It's possible, then, that a Canadian hospital may have no legal duty whatsoever to help an unconscious man right outside its door.
So, here's the question: What should hospital staff do when it learns of a medical emergency just outside of its facility? Officials at the Vancouver hospital say that these matters are best left to EMS personnel, because they are trained to deal with out-of-hospital emergencies, and hospital personnel are not. But if this is true, then why do doctors and nurses regularly intervene when encountering an emergency on the street, sometimes to the point of wresting control from more experienced EMTs and paramedics? I'm not trying to say that doctors and nurses should not get involved; it's just that both perspectives cannot be true.
EMTs and paramedics: Have you ever dealt with this issue personally? Foreign EMS personnel: How does this work where you live? Doctors, nurses, and other hospital staff: How would you handle this situation? And non-medical readers: Do you have any thoughts about this?
Here's the link:
As always, thanks for reading.