Have a Working Knowledge of the Emergency Medical Treatment and Active Labor Act as it Applies to the Intensive Care Unit
Christian Merlo MD, MPH
Nadia N. Hansel MD, MPH
The Emergency Medical Treatment and Active Labor Act (EMTALA) was passed by the U.S. Congress in 1986 to prevent hospitals from rejecting, refusing, or transferring patients because they are unable to pay or because they have public health insurance. The main purpose of EMTALA is to ensure nondiscriminatory patient access to emergency medical care and to prevent the transfer of uninsured patients from private to public hospitals without consideration of medical condition or clinical stability.
Although the act has historically been associated with care in the emergency department, it is important to realize that EMTALA imposes three specific legal duties on the entire hospital, including the intensive care unit (ICU). First, hospitals must perform a screening examination on any person who comes to the hospital to evaluate whether he or she has a medical emergency. Second, if an emergency medical condition exists, hospital staff must stabilize the patient to the best of their capabilities and transfer the patient to another hospital if specialized care is needed and not available at their own institution. Finally, hospitals with specialized capabilities are required to accept patient transfers if they have the capacity to care for them.