EMTALA Emergency Medical Care

Determines whether the patient is in need of urgent care based on the law definition of an emergency condition.

In the text below the tool there is more information about the EMTALA law regulation.

The EMTALA emergency medical care calculator uses the emergency criteria from the law regulation to check whether the patient requires urgent care.

EMTALA is the acronym from Emergency Medical Treatment and Active Labor Act, a law published in 1986 as a framework against any form of discrimination in medical care.

Whilst initially the law was meant at protecting uninsured population from being denied medical case, currently, the use of the criteria has moved towards ensuring that emergency patients receive a standardized screening evaluation of their medical condition before, if needed, they are stabilized and transferred to the appropriate medical unit.

There are two questions that are asked, their answers making up five criteria for the evaluation.

Has the current medical condition which requires urgent care any of the following characteristics?

Places the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy

Is expected to result in serious impairment to bodily functions or

Is expected to result in serious dysfunction of any bodily organ or part

With respect to a pregnant woman who is having contractions:

there is inadequate time to effect a safe transfer to another hospital before delivery, or

that transfer may pose a threat to the health or safety of the woman or the unborn child

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Steps on how to print your input & results:

1. Fill in the calculator/tool with your values and/or your answer choices and press Calculate.

2. Then you can click on the Print button to open a PDF in a separate window with the inputs and results. You can further save the PDF or print it.

Please note that once you have closed the PDF you need to click on the Calculate button before you try opening it again, otherwise the input and/or results may not appear in the pdf.

EMTALA explained

The above calculator is based on the main criteria from EMTALA, the Emergency Medical Treatment and Active Labor Act and is aimed at providing a standardized assessment that emergency specialists can use in reviewing whether a patient requires urgent care or not.

The tool was first published in 1986 with the purpose to protect uninsured population from discrimination in the medical field, so that they are not denied medical care.

The current purpose is to provide a checklist for assessment of medical condition before patient is stabilized and transferred to appropriate level of care.

The 42 U.S. Code § 1395dd - Examination and treatment for emergency medical conditions and women in labor – underlines rules for management of emergency conditions. These are explained below, along with point e), which provides the basis of this calculator.

EMTALA points	Explanation
a) Medical Screening Requirement	The medical unit must provide appropriate medical screening examination to determine whether an emergency condition exists and if so, its nature.
b) Necessary stabilizing treatment	In emergency medical condition and in labor.
c) Restricting transfers	This refers to cessation of transfer until the patient is stable enough.
d) Enforcement	Through civil money penalties or civil enforcement for personal harm, financial loss to other medical facility and limitations on actions.
e) Definitions and what consists an “emergency medical condition”	As presented in the above calculator.
f) Preemption	The right to be seen before others with less severe conditions.
g) Nondiscrimination	Protects against discrimination of all types.
h) No delay in examination or treatment	The patient must be seen at earliest available time.
i) Whistleblower protections	Prevents retaliatory action for voluntarily disclosing information about medical practices.

The rule of the thumb is that if at least one of the conditions described at point e) in EMTALA is present, then the medical emergency is established.

Within this federal law, the condition of active labor is classed as unstable therefore EMTALA is applied not only in emergency rooms but also in perinatal and neonatal nursing units.

There are other more specific stratification tools for use in emergencies, such as the Glasgow Coma Scale or the Revised Trauma Score.

Original source

42 U.S. Code § 1395dd - Examination and treatment for emergency medical conditions and women in labor.

Other references

1. Zibulewsky J. The Emergency Medical Treatment and Active Labor Act (EMTALA): what it is and what it means for physicians. Proc (Bayl Univ Med Cent). 2001; 14(4): 339–346.

2. Mercado-Alvarado J, Oliveras García C. EMTALA: what it is, its origins, and how it functions in Puerto Rico. Bol Asoc Med P R. 2009; 101(3):19-21.

3. Glass DL, Rebstock J, Handberg E. Emergency Treatment and Labor Act (EMTALA). Avoiding the pitfalls. J Perinat Neonatal Nurs. 2004; 18(2):103-14; quiz 115-6.

Specialty: Emergency

Objective: Evaluation

Type: Calculator

No. Of Criteria: 2

Year Of Study: 1986

Abbreviation: EMTALA

Article By: Denise Nedea

Published On: June 21, 2017 · 07:56 AM

Last Checked: June 21, 2017

Next Review: June 21, 2023