Re: Preterm labor/transfer
From: Efrain Ramirez (eramirez@icepr.com)
Wed Jan 31 19:42:00 2001
Bob that it's true BUT -- it also says this:
"Labor is defined as the process of childbirth beginning eith the latent
or early phase of labor nd continuing through the delivery of the
placenta. A woman experiencing contractions is in true labor unless a
physician certifies that, after a reasonable time of observation, the
woman is in false labor."
I can't imagine one trying to convince an inspector of the HCFA that a
lady in 5 cm 80% eff is not in labor.
At Wed, 31 Jan 2001, RModugno@aol.com wrote:
>
>In a message dated 1/30/01 11:49:53 PM Eastern Standard Time,
>islesannie@yahoo.com writes:
>
>> At Tue, 30 Jan 2001, Richard Chudacoff, MD wrote:
>> >
>> >EMTALA says you can't transfer her. I think greater than 4 cms is unstable
>> >for transport.
>> >
>> >--
>> >Richard Chudacoff, MD
>>
>That's not quite correct - if the patient is stable - she may be transferred
>with her permission and the permission of a receiving physician:
>
>EMTALA establishes the following general requirements:
>1)Medical Screening Examination. A hospital that operates an emergency
>department must provide a medical screening examination to anyone on whose
>behalf a request is made for examination or treatment. The purpose of the
>examination is to determine whether or not the individual is in an emergency
>medical condition
>2)Necessary Stabilizing Treatment. If the individual has come to the hospital
>and the hospital has determined that he or she is in an emergency medical
>condition, the hospital must provide further medical examination and
>treatment to stabilize the medical condition.
>3)Restricting Transfers Until Stabilization. A hospital may not transfer an
>individual unless:
>The individual requests transfer having been informed of the hospital's
>obligation to provide further examination and treatment and of the risks of
>transfer, or a physician certifies in writing that the benefits reasonably
>expected from treatment at another facility outweigh the increased risks to
>the individual and/or the unborn child from effecting the transfer (if the
>physician is not present in the emergency department, a "qualified medical
>person" may sign the certification if a physician consulting with that person
>has made the determination that the benefits of transfer outweigh the risks,
>and subsequently countersigns the certification); and
>The transfer is an appropriate transfer.
>4)Appropriate Transfer.
>Transferring hospital provides medical treatment to minimize risks to the
>individual and/or unborn child.
>Receiving facility has available space and qualified personnel to treat the
>individual and has agreed to accept transfer of the individual.
>Transferring hospital sends all medical records related to the emergency
>condition, including emergency medical records, observations of signs and
>symptoms, preliminary diagnosis, treatment provided, results of any tests,
>the informed consent and/or certification provided under EMTALA and the name
>and address of any on-call physician who has refused or failed to appear
>within a reasonable time to provide necessary stabilizing treatment.
>Transfer is effected through qualified personnel and transportation equipment
>as required, including the use of necessary medically appropriate life
>support measures during transfer.
>5)Meet other requirements imposed by the Secretary. (of HHS)
>
>This was taken from this website:
>
> <A HREF="http://www.acutecare.com/emtala.htm">EMTALA: The Emergency Medical Treatment and Active Labor Act</A>
>
>Robert Modugno MD MBA FACOG
>Marietta, GA
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"Life is neither the notes nor the silence between the notes, but the music that
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