reglab/statecodes huggingface dataset:
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7 - Trauma Care Systems › Article 2 - Local EMS Agency Trauma System Requirements › Section 100257 - Data Collection

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The
				  local EMS agency shall develop and implement a standardized data collection
				  instrument and implement a data management system for trauma care.
(1) The system shall include the collection of
				  both prehospital and hospital patient care data, as determined by the local EMS
				  agency;
(2) trauma data shall be
				  integrated into the local EMS agency and State EMS Authority data management system;
				  and
(3) all hospitals that receive
				  trauma patients shall participate in the local EMS agency data collection effort in
				  accordance with local EMS agencies policies and procedures.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7 - Trauma Care Systems › Article 2 - Local EMS Agency Trauma System Requirements › Section 100258 - Trauma System Evaluation

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The
				  local EMS agency shall be responsible for the development and ongoing evaluation of
				  the trauma system.
(b) The local EMS
				  agency shall be responsible for the development of a process to receive information
				  from EMS providers, participating hospitals and the local medical community on the
				  evaluation of the trauma system, including but not limited to:
(1) trauma plan;
(2) triage criteria;
(3) activation of trauma team; and
(4) notification of
				  specialists.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7 - Trauma Care Systems › Article 3 - Trauma Center Requirements › Section 100259 - Level I and Level II Trauma Centers

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A
				  Level I or II trauma center is a licensed hospital which has been designated as a
				  Level I or II trauma center by the local EMS agency. While both Level I and II
				  trauma centers are similar, a Level I trauma center is required to have staff and
				  resources not required of a Level II trauma center. The additional Level I
				  requirements are located in Section
				  100260. Level I and II trauma centers
				  shall have appropriate pediatric equipment and supplies and be capable of initial
				  evaluation and treatment of pediatric trauma patients. Trauma centers without a
				  pediatric intensive care unit, as outlined in (e)(1) of this section, shall
				  establish and utilize written criteria for consultation and transfer of pediatric
				  patients needing intensive care. A Level I or Level II trauma center shall have at
				  least the following:
(1) A trauma program medical
				  director who is a board-certified surgeon, whose responsibilities include, but are
				  not limited to, factors that affect all aspects of trauma care such as:
(A) recommending trauma team physician
				  privileges;
(B) working with nursing and
				  administration to support the needs of trauma patients;
(C) developing trauma treatment
				  protocols;
(D) determining appropriate
				  equipment and supplies for trauma care;
(E) ensuring the development of policies and
				  procedures to manage domestic violence, elder and child abuse and neglect;
(F) having authority and accountability for the
				  quality improvement peer review process;
(G) correcting deficiencies in trauma care or
				  excluding from trauma call those trauma team members who no longer meet
				  standards;
(H) coordinating pediatric
				  trauma care with other hospital and professional services;
(I) coordinating with local and State EMS
				  agencies;
(J) assisting in the
				  coordination of the budgetary process for the trauma program; and
(K) identifying representatives from neurosurgery,
				  orthopaedic surgery, emergency medicine, pediatrics and other appropriate
				  disciplines to assist in identifying physicians from their disciplines who are
				  qualified to be members of the trauma program.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7 - Trauma Care Systems › Article 3 - Trauma Center Requirements › Section 100260 - Additional Level I Criteria

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
In addition to the above requirements, a Level I trauma center
					 shall have:
(a) One of the following
				  patient volumes annually:
(1) a minimum of 1200
				  trauma program hospital admissions, or
(2) a minimum of 240 trauma patients per year
				  whose Injury Severity Score (ISS) is greater than 15, or
(3) an average of 35 trauma patients (with an ISS
				  score greater than 15) per trauma program surgeon per year.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7 - Trauma Care Systems › Article 3 - Trauma Center Requirements › Section 100261 - Level I and Level II Pediatric Trauma Centers

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A Level I or II pediatric trauma center is a
				  licensed hospital which has been designated as a Level I or II pediatric trauma
				  center by the local EMS agency. While both Level I and II pediatric trauma centers
				  are similar, a Level I pediatric trauma center is required to have staff and
				  resources not required of a Level II pediatric trauma center. The additional Level I
				  requirements for pediatric trauma centers are located in Section
				  100262. A Level I or Level II pediatric
				  trauma center shall have at least the following:
(1) A pediatric trauma program medical director
				  who is a board-certified surgeon with experience in pediatric trauma care (may also
				  be trauma program medical director for adult trauma services), whose
				  responsibilities include, but are not limited to, factors that affect all aspects of
				  pediatric trauma care such as:
(A) recommending
				  pediatric trauma team physician privileges;
(B) working with nursing and administration to
				  support the needs of pediatric trauma patients;
(C) developing pediatric trauma treatment
				  protocols:
(D) determining appropriate
				  equipment and supplies for pediatric trauma care;
(E) ensuring the development of policies and
				  procedures to manage domestic violence and child abuse and neglect;
(F) having authority and accountability for the
				  pediatric trauma quality improvement peer review process;
(G) correcting deficiencies in pediatric trauma
				  care or excluding from trauma call those trauma team members who no longer meet
				  standards;
(H) coordinating pediatric
				  trauma care with other hospital and professional services;
(I) coordinating with local and State EMS
				  agencies;
(J) assisting in the
				  coordination of the budgetary process for the trauma program; and
(K) identifying representatives from neurosurgery,
				  orthopedic surgery, emergency medicine, pediatrics and other appropriate disciplines
				  to assist in identifying physicians from their disciplines who have pediatric trauma
				  care experience and who are qualified to be members of the pediatric trauma
				  program.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7 - Trauma Care Systems › Article 3 - Trauma Center Requirements › Section 100262 - Additional Level I Pediatric Trauma Criteria

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
In addition to the above requirements, a Level I pediatric
					 trauma center shall have:
(a) A pediatric
				  trauma program medical director who is a board-certified pediatric surgeon, whose
				  responsibilities include, but are not limited to, factors that affect all aspects of
				  pediatric trauma care.
(b) Additional
				  qualified pediatric surgical specialists or specialty availability on-call and
				  promptly available:
(1) cardiothoracic;
(2) pediatric neurologic;
(3) pediatric ophthalmologic;
(4) pediatric oral or maxillofacial or head and
				  neck; and
(5) pediatric
				  orthopaedic,
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7 - Trauma Care Systems › Article 3 - Trauma Center Requirements › Section 100263 - Level III Trauma Centers

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
A Level III trauma center is a licensed hospital which has been
					 designated as a Level III trauma center by the local EMS agency. A Level III trauma
					 center shall include equipment and resources necessary for initial stabilization and
					 personnel knowledgeable in the treatment of adult and pediatric trauma. A Level III
					 trauma center shall have at least the following:
(a) A trauma program medical director who is a
				  qualified surgical specialist, whose responsibilities include, but are not limited
				  to, factors that affect all aspects of trauma care such as:
(1) recommending trauma team physician
				  privileges;
(2) working with nursing
				  administration to support the nursing needs of trauma patients;
(3) developing trauma treatment
				  protocols;
(4) having authority and
				  accountability for the quality improvement peer review process;
(5) correcting deficiencies in trauma care or
				  excluding from trauma call those trauma team members who no longer meet the
				  standards of the quality improvement program; and
(6) assisting in the coordination of budgetary
				  process for the trauma program.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7 - Trauma Care Systems › Article 3 - Trauma Center Requirements › Section 100264 - Level IV Trauma Center

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
A Level IV trauma center is a licensed hospital which has been
					 designated as a Level IV trauma center by the local EMS agency. A Level IV trauma
					 center shall include equipment and resources necessary for initial stabilization and
					 personnel knowledgeable in the treatment of adult and pediatric trauma. A Level IV
					 trauma center shall have at least the following:
(a) A trauma program medical director who is a
				  qualified specialist whose responsibilities include, but are not limited to, factors
				  that affect all aspects of trauma care, including pediatric trauma care, such as:
(1) recommending trauma team physician
				  privileges;
(2) working with nursing
				  administration to support the nursing needs of trauma patients;
(3) developing treatment protocols;
(4) having authority and accountability for the
				  quality improvement peer review process;
(5) correcting deficiencies in trauma care or
				  excluding from trauma call those trauma team members who no longer meet the
				  standards of the quality improvement program; and
(6) assisting in the coordination of the budgetary
				  process for the trauma program.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7 - Trauma Care Systems › Article 4 - Quality Improvement › Section 100265 - Quality Improvement

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Trauma centers of all levels shall have a quality improvement
					 process to include structure, process, and outcome evaluations which focus on
					 improvement efforts to identify root causes of problems, intervene to reduce or
					 eliminate these causes, and take steps to correct the process. In addition the
					 process shall include:
(a) A detailed audit
				  of all trauma-related deaths, major complications and transfers (including
				  interfacility transfer);
(b) A
				  multidisciplinary trauma peer review committee that includes all members of the
				  trauma team;
(c) Participation in the
				  trauma system data management system;
(d) Participation in the local EMS agency trauma
				  evaluation committee; and
(e) Each
				  trauma center shall have a written system in place for patients, parents of minor
				  children who are patients, legal guardian(s) of children who are patients, and/or
				  primary caretaker(s) of children who are patients to provide input and feedback to
				  hospital staff regarding the care provided to the child.
(f) Following of applicable provisions of Evidence
				  Code Section
				  1157.7 to ensure
				  confidentiality.
1. New article 4
					 (section 100265) and section filed 7-13-99;
					 operative 8-12-99 (Register 99, No. 29).
Note: Authority cited: Sections
						1797.107
						and
						1798.161,
						Health and Safety Code. Reference: Section
						1798.161,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7 - Trauma Care Systems › Article 5 - Transfer of Trauma Patients › Section 100266 - Interfacility Transfer of Trauma Patients

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Patients may be transferred between and from
				  trauma centers providing that:
(1) any transfer
				  shall be, as determined by the trauma center surgeon of record, medically prudent;
				  and
(2) in accordance with local EMS
				  agency interfacility transfer policies.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.101 - Cardiac Catheterization Laboratory. "Cardiac Catheterization Laboratory" or "Cath Lab" Means the Setting Within the Hospital Where Diagnostic and Therapeutic Procedures Are Performed on Patients with Cardiovascular Disease

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New chapter
					 7.1 (articles 1-5, sections
					 100270.101-1000270.127), article 1
					 (sections 100270.101-100270.120) and section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103
						and
						1797.176,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.102 - Cardiac Catheterization Team

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Cardiac catheterization team" means the specially trained
					 health care professionals that perform percutaneous coronary intervention. It may
					 include, but is not limited to, an interventional cardiologist, mid-level
					 practitioners, registered nurses, technicians, and other health care
					 professionals.
1. New section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103
						and
						1797.176,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.103 - Clinical Staff

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Clinical staff" means individuals that have specific training
					 and experience in the treatment and management of ST-Elevation Myocardial Infarction
					 (STEMI) patients. This includes, but is not limited to, physicians, registered
					 nurses, advanced practice nurses, physician assistants, pharmacists, and
					 technologists.
1. New section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103
						and
						1797.176,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.104 - Emergency Medical Services Authority

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Emergency Medical Services Authority" or "EMS Authority" or
					 "EMSA" means the department in California responsible for the coordination and
					 integration of all state activities concerning EMS.
1. New section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.1,
						1797.107
						and
						1797.54,
						Health and Safety Code. Reference: Sections
						1797.100
						and
						1797.103,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.105 - Immediately Available

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Immediately available" means:
(a) Unencumbered by conflicting duties or
				  responsibilities.
(b) Responding without
				  delay upon receiving notification.
(c)
				  Being physically available to the specified area of the hospital when the patient is
				  delivered in accordance with local EMS agency policies and procedures.
1. New section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103
						and
						1797.176,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.106 - Implementation

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Implementation," "implemented," or "has implemented" means the
					 development and activation of a STEMI Critical Care System Plan by the local EMS
					 agency, including the prehospital and hospital care components in accordance with
					 the plan.
1. New section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103
						and
						1797.176,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.107 - Interfacility Transfer

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Interfacility transfer" means the transfer of a STEMI patient
					 from one acute general care facility to another acute general care
					 facility.
1. New section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103,
						1797.176
						and
						1798.170,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.108 - Local Emergency Medical Services Agency

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Local emergency medical services agency" or "local EMS agency"
					 means the agency, department, or office having primary responsibility for
					 administration of emergency medical services in a county or region and which is
					 designated pursuant Health and Safety Code commencing with section
					 1797.200.
1. New section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107,
						1797.200
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103
						and
						1797.176,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.109 - Percutaneous Coronary Intervention (Pci)

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Percutaneous coronary intervention" or "PCI" means a procedure
					 used to open or widen a narrowed or blocked coronary artery to restore blood flow
					 supplying the heart, usually done on an emergency basis for a STEMI
					 patient.
1. New section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103
						and
						1797.176,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.110 - Quality Improvement

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Quality improvement" or "QI" means methods of evaluation that
					 are composed of structure, process, and outcome evaluations that focus on
					 improvement efforts to identify root causes of problems, intervene to reduce or
					 eliminate these causes, and take steps to correct the process, and recognize
					 excellence in performance and delivery of care.
1. New section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.103,
						1797.107,
						1797.174,
						1797.176
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.174,
						1797.202,
						1797.204,
						1797.220
						and
						1798.175,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.111 - ST-Elevation Myocardial Infarction (Stemi)

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"ST-Elevation Myocardial Infarction" or "STEMI" means a clinical
					 syndrome defined by symptoms of myocardial infarction in association with ST-segment
					 elevation on Electrocardiogram (ECG).
1. New section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103
						and
						1797.176,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.112 - Stemi Care

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"STEMI care" means emergency cardiac care, for the purposes of
					 these regulations.
1. New section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103
						and
						1797.176,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.113 - Stemi Medical Director

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"STEMI medical director" means a qualified board-certified
					 physician by the American Board of Medical Specialties (ABMS) as defined by the
					 local EMS agency and designated by the hospital that is responsible for the STEMI
					 program, performance improvement, and patient safety programs related to a STEMI
					 critical care system.
1. New section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103
						and
						1797.176,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.114 - Stemi Patient

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"STEMI patient" means a patient with symptoms of myocardial
					 infarction in association with ST-Segment Elevation in an ECG.
1. New section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103,
						1797.176
						and
						1797.220,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.115 - Stemi Program

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"STEMI program" means an organizational component of the
					 hospital specializing in the care of STEMI patients.
1. New section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103
						and
						1797.176,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.116 - Stemi Program Manager

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"STEMI program manager" means a registered nurse or qualified
					 individual as defined by the local EMS agency, and designated by the hospital
					 responsible for monitoring, coordinating and evaluating the STEMI
					 program.
1. New section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103
						and
						1797.176,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.117 - Stemi Receiving Center (Src)

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"STEMI receiving center" or "SRC" means a licensed general acute
					 care facility that meets the minimum hospital STEMI care requirements pursuant to
					 Section 100270.124 and is able to perform
					 PCI.
1. New section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103,
						1797.176
						and
						1797.220,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.118 - Stemi Referring Hospital (Srh)

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"STEMI referring hospital" or "SRH" means a licensed general
					 acute care facility that meets the minimum hospital STEMI care requirements pursuant
					 to Section 100270.125.
1. New section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103,
						1797.176
						and
						1797.220,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.119 - Stemi Critical Care System

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"STEMI critical care system" means a critical care component of
					 the EMS system developed by a local EMS agency that links prehospital and hospital
					 care to deliver treatment to STEMI patients.
1. New section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103
						and
						1797.176,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 1 - Definitions › Section 100270.120 - Stemi Team

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"STEMI team" means clinical personnel, support personnel, and
					 administrative staff that function together as part of the hospital's STEMI
					 program.
1. New section
					 filed 4-19-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103
						and
						1797.176,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 2 - Local EMS Agency Stemi Critical Care System Requirements › Section 100270.121 - Stemi Critical Care System Plan

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The
				  local EMS agency may develop and implement a STEMI critical care system.
(b) The local EMS agency implementing a STEMI
				  critical care system shall have a STEMI Critical Care System Plan approved by the
				  EMS Authority prior to implementation.
(c) A STEMI Critical Care System Plan submitted to
				  the EMS Authority shall include, at a minimum, all of the following components:
(1) The names and titles of the local EMS agency
				  personnel who have a role in a STEMI critical care system.
(2) The list of STEMI designated facilities with
				  the agreement expiration dates.
(3) A
				  description or a copy of the local EMS agency's STEMI patient identification and
				  destination policies.
(4) A description
				  or a copy of the method of field communication to the receiving hospital specific to
				  STEMI patient, designed to expedite time-sensitive treatment on arrival.
(5) A description or a copy of the policy that
				  facilitates the inter-facility transfer of a STEMI patient.
(6) A description of the method of data collection
				  from the EMS providers and designated STEMI hospitals to the local EMS agency and
				  the EMS Authority.
(7) A policy or
				  description of how the local EMS agency integrates a receiving center in a
				  neighboring jurisdiction.
(8) A
				  description of the integration of STEMI into an existing quality improvement
				  committee or a description of any STEMI specific quality improvement
				  committee.
(9) A description of programs
				  to conduct or promote public education specific to cardiac care.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 2 - Local EMS Agency Stemi Critical Care System Requirements › Section 100270.122 - Stemi Critical Care System Plan Updates

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The local EMS agency shall submit an annual
				  update of its STEMI Critical Care System Plan, as part of its annual EMS plan
				  submittal, which shall include, at a minimum, all the following:
(1) Any changes in a STEMI critical care system
				  since submission of the prior annual plan update or a STEMI Critical Care System
				  Plan addendum.
(2) The status of a STEMI
				  critical care system goals and objectives.
(3) The STEMI critical care system quality
				  improvement activities.
(4) The progress
				  on addressing action items and recommendations provided by the EMS Authority within
				  the STEMI Critical Care System Plan or status report approval letter if
				  applicable.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 3 - Prehospital Stemi Critical Care System Requirements › Section 100270.123 - EMS Personnel and Early Recognition

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  The local EMS agency with an established STEMI critical care system shall have
				  protocols for the identification and treatment of STEMI patients, including
				  paramedic performance of a 12-lead ECG and determination of the patient
				  destination.
(b) The findings of 12-lead
				  ECG shall be assessed and interpreted through one or more of the following methods:
(1) Direct paramedic interpretation.
(2) Automated computer algorithm.
(3) Wireless transmission to facility followed by
				  physician interpretation or confirmation.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 4 - Stemi Critical Care Facility Requirements › Section 100270.124 - Stemi Receiving Center Requirements

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  The following minimum criteria shall be used by the local EMS agency for the
				  designation of a STEMI receiving center:
(1) The
				  hospital shall have established protocols for triage, diagnosis, and Cath lab
				  activation following field notification.
(2) The hospital shall have a single call
				  activation system to activate the Cardiac Catheterization Team directly.
(3) Written protocols shall be in place for the
				  identification of STEMI patients.
(A) At a
				  minimum, these written protocols shall be applicable in the intensive care
				  unit/coronary care unit, Cath lab and the emergency department.
(4) The hospital shall be available for treatment
				  of STEMI patients twenty-four (24) hours per day, seven (7) days per week, three
				  hundred and sixty-five (365) days per year.
(5) The hospital shall have a process in place for
				  the treatment and triage of simultaneously arriving STEMI patients.
(6) The hospital shall maintain STEMI team and
				  Cardiac Catheterization Team call rosters.
(7) The Cardiac Catheterization Team, including
				  appropriate staff determined by the local EMS agency, shall be immediately
				  available.
(8) The hospital shall agree
				  to accept all STEMI patients according to the local policy.
(9) STEMI receiving centers shall comply with the
				  requirement for a minimum volume of procedures for designation required by the local
				  EMS agency.
(10) The hospital shall have
				  a STEMI program manager and a STEMI medical director.
(11) The hospital shall have job descriptions and
				  organizational structure clarifying the relationship between the STEMI medical
				  director, STEMI program manager, and the STEMI team.
(12) The hospital shall participate in the local
				  EMS agency quality improvement processes related to a STEMI critical care
				  system.
(13) A STEMI receiving center
				  without cardiac surgery capability on-site shall have a written transfer plan and
				  agreements for transfer to a facility with cardiovascular surgery
				  capability.
(14) A STEMI receiving
				  center shall have reviews by local EMS agency or other designated agency conducted
				  every three years.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 4 - Stemi Critical Care Facility Requirements › Section 100270.125 - Stemi Referring Hospital Requirements

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  The following minimum criteria shall be used by the local EMS agency for designation
				  of a STEMI referring hospital:
(1) The hospital
				  shall be committed to supporting the STEMI Program.
(2) The hospital shall be available to provide
				  care for STEMI patients twenty-four (24) hours per day, seven (7) days per week,
				  three hundred and sixty-five (365) days per year.
(3) Written protocols shall be in place to
				  identify STEMI patients and provide an optimal reperfusion strategy, using
				  fibrinolytic therapy.
(4) The emergency
				  department shall maintain a standardized procedure for the treatment of STEMI
				  patients.
(5) The hospital shall have a
				  transfer process through interfacility transfer agreements, and have pre-arranged
				  agreements with EMS ambulance providers for rapid transport of STEMI patients to a
				  SRC.
(6) The hospital shall have a
				  program to track and improve treatment of STEMI patients.
(7) The hospital must have a plan to work with a
				  STEMI receiving center and the local EMS agency on quality improvement
				  processes.
(8) A STEMI referring
				  hospital designated by the local EMS agency shall have a review conducted every
				  three years.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 5 - Data Management, Quality Improvement and Evaluations › Section 100270.126 - Data Management

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The
				  local EMS agency shall implement a standardized data collection and reporting
				  process for a STEMI critical care system.
(b) The system shall include the collection of
				  both prehospital and hospital patient care data, as determined by the local EMS
				  agency.
(c) The prehospital STEMI
				  patient care elements selected by the local EMS agency shall be compliant with the
				  most current version of the California EMS Information Systems (CEMSIS) database,
				  and the National EMS Information System (NEMSIS).
(d) All hospitals that receive STEMI patients via
				  EMS shall participate in the local EMS agency data collection process in accordance
				  with local EMS agency policies and procedures.
(e) The prehospital care record and the hospital
				  data elements shall be collected and submitted to the local EMS agency, and
				  subsequently to the EMS Authority, on no less than a quarterly basis and shall
				  include, but not be limited to, the following:
(1)
				  The STEMI patient data elements:
(A) EMS ePCR
				  Number.
(B) Facility.
(C) Name: Last, First.
(D) Date of Birth.
(E) Patient Age.
(F) Patient Gender.
(G) Patient Race.
(H) Hospital Arrival Date.
(I) Hospital Arrival Time.
(J) Dispatch Date.
(K) Dispatch Time.
(L) Field ECG Performed.
(M) 1st ECG Date.
(N) 1st ECG Time.
(O) Did the patient suffer out-of-hospital cardiac
				  arrest.
(P) CATH LAB
				  Activated.
(Q) CATH LAB Activation
				  Date.
(R) CATH LAB Activation
				  Time.
(S) Did the patient go to the CATH
				  LAB.
(T) CATH LAB Arrival
				  Date.
(U) CATH LAB Arrival
				  Time.
(V) PCI Performed.
(W) PCI Date.
(X) PCI Time.
(Y) Fibrinolytic Infusion.
(Z) Fibrinolytic Infusion Date.
(AA) Fibrinolytic Infusion Time.
(BB) Transfer.
(CC) SRH ED Arrival Date.
(DD) SRH ED Arrival Time.
(EE) SRH ED Departure Date.
(FF) SRH ED Departure Time.
(GG) Hospital Discharge Date.
(HH) Patient Outcome:
(II) Primary and Secondary Discharge
				  Diagnosis.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.1 - ST-Elevation Myocardial Infarction Critical Care System › Article 5 - Data Management, Quality Improvement and Evaluations › Section 100270.127 - Quality Improvement and Evaluation Process

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Each STEMI critical care system shall have a
				  quality improvement process that shall include, at a minimum:
(1) Evaluation of program structure, process, and
				  outcome.
(2) Review of STEMI-related
				  deaths, major complications, and transfers.
(3) A multidisciplinary STEMI Quality Improvement
				  Committee, including both prehospital and hospital members.
(4) Participation in the QI process by all
				  designated STEMI centers and prehospital providers involved in the STEMI critical
				  care system.
(5) Evaluation of regional
				  integration of STEMI patient movement.
(6) Compliance with the California Evidence Code,
				  Section
				  1157.7 to ensure
				  confidentiality, and a disclosure-protected review of selected STEMI
				  cases.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.2 - Stroke Critical Care System › Article 1 - Definitions › Section 100270.200 - Acute Stroke Ready Hospital

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Acute stroke-ready hospitals" or "Satellite stroke centers"
					 means a hospital able to provide the minimum level of critical care services for
					 stroke patients in the emergency department, and are paired with one or more
					 hospitals with a higher level of stroke services.
1. New chapter
					 7.2, (articles 1-5, sections
					 100270.200-100270.229), article 1
					 (sections 100270.200-100270.219) and section
					 filed 4-17-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.94,
						1797.103
						and
						1797.176,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.2 - Stroke Critical Care System › Article 1 - Definitions › Section 100270.201 - Board-Certified

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Board-certified" means a physician who has fulfilled all the
					 Accreditation Council for Graduate Medical Education (ACGME) requirements in a
					 specialty field of practice, and has been awarded a certification by an American
					 Board of Medical Specialties (ABMS) approved program.
1. New section
					 filed 4-17-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103
						and
						1797.176,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.2 - Stroke Critical Care System › Article 1 - Definitions › Section 100270.202 - Board-Eligible

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Board-eligible" means a physician who has applied to a
					 specialty board examination and has completed the requirements and is approved to
					 take the examination by ABMS. Board certification must be obtained within the
					 allowed time by ABMS from the first appointment.
1. New section
					 filed 4-17-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107,
						1797.176
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103
						and
						1797.176,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.2 - Stroke Critical Care System › Article 1 - Definitions › Section 100270.203 - Comprehensive Stroke Center

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Comprehensive stroke center" means a hospital with specific
					 abilities to receive, diagnose and treat all stroke cases and provide the highest
					 level of care for stroke patients.
1. New section
					 filed 4-17-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.94,
						1797.103
						and
						1797.176,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.2 - Stroke Critical Care System › Article 1 - Definitions › Section 100270.204 - Clinical Stroke Team

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Clinical stroke team" means a team of healthcare professionals
					 who provide care for the stroke patient and may include, but is not limited to,
					 neurologists, neuro-interventionalists, neurosurgeons, anesthesiologists, emergency
					 medicine physicians, registered nurses, advanced practice nurses, physician
					 assistants, pharmacists, and technologists.
1. New section
					 filed 4-17-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107,
						1797.176
						and
						1798.150,
						Health and Safety Code. Reference: Sections
						1797.103
						and
						1797.176,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.2 - Stroke Critical Care System › Article 1 - Definitions › Section 100270.205 - Emergency Medical Services Authority

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Emergency Medical Services Authority" or "EMS Authority" means
					 the department in California that is responsible for the coordination and the
					 integration of all state activities concerning emergency medical services
					 (EMS).
1. New section
					 filed 4-17-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Section
						1797.107,
						Health and Safety Code. Reference: Sections
						1797.54,
						1797.100
						and
						1797.103,
						Health and Safety Code.
California Code of Regulations › Title 22 - Social Security › Division 9 - Prehospital Emergency Medical Services › Chapter 7.2 - Stroke Critical Care System › Article 1 - Definitions › Section 100270.206 - Local Emergency Medical Services Agency

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Local emergency medical services agency" or "local EMS agency"
					 means the agency, department, or office having primary responsibility for
					 administration of emergency medical services in a county and which is designated
					 pursuant Health and Safety Code section
					 1797.200.
1. New section
					 filed 4-17-2019; operative 7-1-2019 (Register 2019, No.
					 16).
Note: Authority cited: Sections
						1797.107
						and
						1797.176,
						Health and Safety Code. Reference: Sections
						1797.94
						and
						1797.200,
						Health and Safety Code.