EMTALA Emergency Medical Condition Checklist

General & Administrative
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Emergency Medical Condition Checklist[html]
<strong>Note: This checklist is for chart review purposes only.</strong> Patient care should not be delayed to use this resource.[/html]
A medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in—
[select name="Q1" value="YES=1|NO=0"] <-- (i) placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy,
[select name="Q2" value="YES=1|NO=0"] <-- (ii) serious impairment to bodily functions, or
[select name="Q3" value="YES=1|NO=0"] <-- (iii) serious dysfunction of any bodily organ or part; or
(B) with respect to a pregnant woman who is having contractions—
[select name="Q4" value="YES=1|NO=0"] <-- (i) that there is inadequate time to effect a safe transfer to another hospital before delivery, or
[select name="Q5" value="YES=1|NO=0"] <-- (ii) that transfer may pose a threat to the health or safety of the woman or the unborn child.

RESULT --> [calc memo="interpretation" value="score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5);score>0?'An Emergency Medical Condition is Present':'An Emergency Medical Condition May Not be Present'"]
[html]<hr>[/html][checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"][html]
reference: <a href="http://www.law.cornell.edu/uscode/text/42/1395dd" target="_blank">US Code EMTALA text</a>, <a href="http://www.fpnotebook.com/Manage/Legal/RskMngmnt.htm" target="_blank">FP Notebook Risk Management</a>[/html][/conditional]
Emergency Medical Condition Checklist
Note: This checklist is for chart review purposes only. Patient care should not be delayed to use this resource.

A medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in—
<-- (i) placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy,
<-- (ii) serious impairment to bodily functions, or
<-- (iii) serious dysfunction of any bodily organ or part; or
(B) with respect to a pregnant woman who is having contractions—
<-- (i) that there is inadequate time to effect a safe transfer to another hospital before delivery, or
<-- (ii) that transfer may pose a threat to the health or safety of the woman or the unborn child.

RESULT --> interpretationscore=(Q1)+(Q2)+(Q3)+(Q4)+(Q5);score>0?'An Emergency Medical Condition is Present':'An Emergency Medical Condition May Not be Present'

display/hide references
Result - Copy and paste this output:

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