I appreciate as many responses as possible due to the urgency and seriousness of this matter:
We are having a multi-disciplinary discussion in regards to adults and children involved in a serious MVC being brought being in as patients via EMS to our Emergency Department (free standing Children's Hospital). The issue is that the parents do not want to be separated from their child / children, and their child / children need to be brought to our facility for appropriate care. According to EMS,the parents are deemed "not so hurt, but should be seen by an MD". In this case, the call comes through the radio, and we have to "accept" or "refuse" the patient(s).
We are aware of EMTLA, and when an adult has walked in or been dropped off at our facility, we stabilize and transfer, no questions asked. But what is the rule if EMS calls with an adult patient and asks for us to "accept" them as a patient. As it stands, trauma patients > 15 years old get deferred to the adult hospital (less than half a mile away). Our PEM group (including myself) is not comfortable with accepting these adult patients, and we identify this as a huge risk and liability.
What is the practice at your facility, and does anyone know the legality of "accepting" patients involved in a traumatic event that you and your facility are not trained to treat? (ie adults not previously seen by any of your subspecialists)
Michelle K. Arzubi-Hughes, D.O., FAAP
Children’s Hospital of the Kings’ Daughters
Pediatric Emergency Medicine Attending
Associate Medical Director for Trauma
Chair of Resuscitation Outcomes Committee
Assistant Professor of Pediatrics
Eastern Virginia Medical School, Department of Pediatrics
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