Biomedical Engineering Reference
In-Depth Information
12. What is the institution's threshold response
in such situations (e.g., any initial evaluation
provided; immediate diversion to designated
facility; patients presenting with symptoms
covered by emergency-response situation, as
well as other symptoms)?
13. Can medical-screening exam procedures be
altered due to concerns over contamination
(e.g., performed outside)?
14. Will response differ by acuity of circum-
stances (e.g., mass disaster vs. intermittent
flow of affected patients)?
15. How will EMTALA compliance be demon-
strated and/or documented in the event that
an emergency-response plan is implemented?
16. Does the organization have a contingency
plan if a potentially exposed patient presents,
but the case must first be evaluated by
law enforcement or public health? Does this
constitute an “undue delay” under EMTALA?
17. What is facility's obligation, if a patient is
diverted elsewhere, to ensure that patient
transfer is effectuated?
18. Have state or local authorities made decla-
rations that will protect the organization in
circumstances where an emergency is not
“national,” and therefore does not trigger
protection from sanctions in the regulations?
19. If the facility in question is the designated
treatment facility, how are existing patients
handled? What happens once capacity is
reached? Does the designated facility have
a memorandum of understanding (MOU) or
mutual-aid agreement with other facilities, or
with state or local government?
20. Has there been a presidential declaration of
emergency that suspends EMTALA obliga-
tions? Will some or all EMTALA obligations
be suspended or waived in the event of a local
emergency in the absence of a federal or local
declaration?
23
C. Patient Tracking and Placement
In a mass-casualty event, organizations may be
over-whelmed with a sudden influx of patients. It
is essential for facilities to both track and be able
to report on these patients.
1. Does the organization have an identified
triage area for large numbers of incoming
patients?
a. Has the organization identified secondary
triage site(s) if its original triage site
becomes overwhelmed by an influx of
patients?
b. Is the organization able to staff and supply
such site(s)?
c. If the organization utilizes secondary sites,
might they be separated by purpose (e.g.,
all patients needing decontamination in
one area, those not needing decontamina-
tion into another)?
d. Are such secondary site(s) separate from
staging areas for any human resources and
other resources?
e. Can the triage zone accommodate decon-
tamination procedures, if needed?
2. Have tracking forms and other tools been made
readily available in the emergency department
and in the Command Center to permit manual
tracking of incoming patients?
3. Does the organization have a method (and
the necessary paper forms and supplies) for
recording patient medical information when
patient volume or other conditions do not
permit the use of computerized systems? Does
the organization have a plan to record manually
gathered information into computer systems
when conditions permit?
4. Where will a large number of incoming
patients be housed? What portions of the
facility can be converted to patient care on
short notice?
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To date, CMS has not stated this explicitly, but it is important to note that policy in this area is evolving.
