The EMTALA is a federal law established in 1986 that requires hospitals or other acute care facilities who offer emergency services to provide MSE to each person presenting to the emergency department to determine if a medical emergency exists. MSE is beyond initial triage. EMTALA requires the assessment of a patient for the existence of an emergency medical condition before the patient can be transferred or released from the emergency department. The EMTALA Interpretive Guidelines identify the licensed registered nurse to be considered qualified medical personnel who can perform the EMTALA MSE and circumstances where the registered nurse consult with a physician. The licensed practical nurse may assist the registered nurse in performing the MSE collecting the information and data and performing a focused assessment. The MSE requires a comprehensive assessment. The licensed practical nurse should use the Scope of Practice Decision Tree to determine if these activities are within the licensed practical nurse's legal and individual scope of practice.