The World’s Okayest Medic Podcast Sunday Coffee Talk (9/21/25)
Sep 21, 2025
In this engaging discussion, the hosts tackle the perils of inappropriate OB transfers and the crucial policies that protect laboring patients. They explore the risks faced during transport, including assessing labor signs and the dangers of delivering in non-hospital settings. The conversation shifts to the importance of situational awareness in emergency response, emphasizing accountability within organizations. Ultimately, they challenge listeners to uphold high standards in medical practice and maintain vigilance for patient safety.
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Questionable High-Risk OB Transfer
- Mike Caroncio described a high-risk OB transfer where he felt the sending facility may have underplayed labor signs.
- The team transported the patient and she did not deliver en route, but Mike later questioned whether they should have refused the flight.
Require Pre-Transport OB Assessment
- Do require a trained pre-transport OB assessment including cervical exam and contraction monitoring for high-risk transfers.
- Call on-call medical control for a physician-to-physician discussion when in doubt about transporting.
EMTALA And Inter-Facility Context
- EMTALA prohibits inappropriate labor transfers when transport risks outweigh staying at the facility.
- Inter-facility context matters because the patient remains under hospital care and refusing unsafe transport can be lawful and appropriate.