NoDumpingIn U.S. academic emergency departments, decisions to accept patients is typically easy, because you have ready access to on-call physicians. When in doubt, accept transfer patients and sort things out later.
  • What are the obligations for those transferring patients to other EDs? 
  • What do the EMTALA (a.k.a. “anti-dumping”) rules say?
  • When can you transfer unstable patients?

As a general rule, the liability falls upon the transferring site and physician. So be sure that your patient won’t decompensate in the ambulance during transfer. So, don’t transfer that CP patient who is getting ruled-out for an MI or ACS no matter how good they look. Patients need to be stable for transfer.

Anyone with pearls to share?

Thanks to @EMurgentologist for tweeting me the idea!
Feel free to download this card and print on a 4” x 6” index card.


Michelle Lin, MD
ALiEM Editor-in-Chief
Academy Endowed Chair of EM Education
Professor of Clinical Emergency Medicine
University of California, San Francisco
Michelle Lin, MD
Michelle Lin, MD

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