Suture Removal without Medical Screening?

Specialties Emergency

Published

Specializes in Emergency Room.

Our ER is constantly increasing in patient visits, as are most ER's. Does anyone know if it is an EMTALA violation to remove sutures by a nurse without a medical screening by a "medical provider." A protocol would be in place for wound description and documentation of suture removal. Simply put does an emergency room patient with a chief complaint of suture removal have to see a MD, PA, or NP.

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Specializes in Emergency, Med/Surg.

I don't believe it's an EMTALA violation, but your physician group's legal people may take issue with it. All of our suture removals need a provider evaluation. It literally takes them 30 seconds to look and make sure there is no s/s of infection or poor healing.

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Our hospital screens suture removal to the clinic or their PCP unless there is any s/s of infection etc. it is not an emergency and therefore can be seen in the clinic.

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Specializes in ER, ICU.

Our triage nurse will remove sutures. The patient is not charged as the removal fee is included in placing them. They create a patient chart and document what was done. If there is any reason to involve a provider that is done.

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Specializes in Emergency Room.

Nurse2033, we are basically there. Admin still wants us to have a PA give a quick blessing. I am curious how your admin views EMTALA on this matter.

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From where I came, patients could have sutures removed by the RN without seeing a doc if (a) sutures were put in by our docs, (b) it's within the time frame recommended by the doc when the sutures were placed, © the patient had NO COMPLAINT... there is no chief complaint, only a request..., (d) the doc didn't order follow-up or re-evaluation on the original d/c instructions, and (e) the patient wasn't requesting to see the doc... this required, of course, that the patient was deemed competent at both the original d/c and upon their return.

It was not deemed an EMTALA violation because the patient had no complaint and wasn't requesting to see a physician. We never had a problem with it.

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Specializes in ER, progressive care.

Our triage nurse removes sutures/staples in triage. Patient chart is created to document and a provider will go out there just to do a brief check and then off they go.

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