# 3668
Hospital Emergency rooms get slammed every winter with influenza cases, often overloaded to the point that they have to close to emergency traffic, simply because they can’t handle the load.
This year, with pandemic H1N1 expected to infect tens of millions of Americans, Emergency rooms may find themselves under even greater strain than normal.
Finding ways to deal with an influx of patients (and their families), most of whom are either mildly ill or the `worried well’, while still providing emergency care to those who really need it will be a huge challenge.
The problem is, under the provisions of the EMTALA act (Emergency Medical Treatment and Active Labor Act), no one can be turned away from a `participating hospital’ emergency room until they have been at least examined, and stabilized (if necessary).
Which, while protective of patients in normal times, presents serious legal and logistical challenges to hospitals dealing with an influx of pandemic flu patients.
The CMS (Centers for Medicare & Medicaid) have issued new guidelines that allow hospitals to set up special flu triage centers away from their emergency rooms.
I’ve not found the new guidelines which were reportedly sent to hospitals around the country yet, but I’ll post a link if I do.
This article, which appears in HealthLeaders Media, was posted by Chuck on FluTrackers. Follow the links to read about it, and some of the caveats involved, in their entirety.
Feds Clarify Hospital Triage Rules in Event of H1N1 Frenzy
Cheryl Clark, for HealthLeaders Media, August 25, 2009
Hospital and public health officials who worry about being deluged this fall by sick and worried well patients fearing H1N1 now have comforting federal guidance on how to re-direct crowds without violating the law.
First, jammed hospital emergency departments can set up alternate screening sites elsewhere on campus, with personnel stationed outside the emergency department to log in and redirect patients seeking care to that alternate site.
This triage system is acceptable as long as the personnel are qualified physicians, RNs, physician's assistants or nurses trained to perform such exams.
Second, hospitals may set up screening at an off-campus site if it is controlled by the hospital. And hospital and community officials may encourage the public to go to these sites instead of the hospital for screening for influenza-like illness.
Third, hospitals and community health officials may encourage the public to go to those sites instead of the hospital for influenza screening.
And fourth, the required medical screening exam does not need to be an extensive work-up in every patient's case.
The guidance was issued in a fact sheet distributed to hospitals by the Centers for Medicare and Medicaid Services in response to hospital and agency concerns.
