Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 6 - Pediatric Trauma Centers › Subchapter 1 - Tertiary Pediatric Trauma Centers › Rule 15-12-32-6.1.9 - Required Clinical Components

Current through June 25, 2024
1. Tertiary
					 pediatric trauma centers must maintain published call schedules and have the
					 following physician coverage immediately available 24 hours/day:
2. Pediatric Emergency Medicine (in-house 24
					 hours/day). Emergency Physician and/or mid-level provider (Physician
					 Assistant/Nurse Practitioner) must be in the specified trauma resuscitation
					 area upon patient arrival. The ED liaison on the trauma team must be board
					 certified, maintain 48 hours of trauma related CME over a three year period,
					 and must maintain current ATLS certification. The liaison must attend a minimum
					 of 50% of peer review committee meetings annually and must participate in the
					 Multidisciplinary Trauma Committee.
3. Trauma/General/Pediatric Surgery (in-house
					 24 hours/day). The surgeon covering pediatric trauma call must be unencumbered
					 and immediately available to respond to the pediatric trauma patient. The 24
					 hour-in-house availability of the attending surgeon is the most direct method
					 for providing this involvement. A PGY 4 or 5 resident may be approved to begin
					 the resuscitation while awaiting the arrival of the attending surgeon but
					 cannot be considered a replacement for the attending surgeon in the ED. The
					 surgeon is expected to be in the ED upon arrival of the seriously injured
					 pediatric patient. The surgeon's participation in major therapeutic decisions,
					 presence in the ED for major resuscitation, and presence at operative
					 procedures is mandatory. There must be a back-up surgeon schedule published.
					 The surgeon on-call must be dedicated to the trauma center and not on-call at
					 any other hospital while on trauma call. A system must be developed to assure
					 early notification of the on-call surgeon and compliance with these criteria
					 and their appropriateness must be documented and monitored by the PI process.
					 The surgery liaison on the trauma team must be board certified, maintain 48
					 hours of trauma related CME over a three year period, and must maintain current
					 ATLS certification. The liaison must attend a minimum of 50% of peer review
					 committee meetings annually and must participate in the Multidisciplinary
					 Trauma Committee. Response time for Alpha Alert/Activations is 15 minutes and
					 starts at patient arrival or EMS notification, whichever is shorter. Response
					 time for Bravo Alerts/Activations is 20 minutes from patient arrival.
4. Orthopedic Surgery. The pediatric
					 orthopedic liaison on the pediatric trauma team must be board certified,
					 maintain 48 hours of trauma related CME over 3 years, and it is desirable to
					 maintain current ATLS certification. The orthopedic liaison to the pediatric
					 trauma team must attend a minimum of 50% of the peer review committees annually
					 and participate in the Multidisciplinary Trauma Committee. It is desirable to
					 have the orthopedic surgeon dedicated to the pediatric trauma center solely
					 while on-call, but if not dedicated, a published back-up call schedule must be
					 available. Response time for all trauma activations is 60 minutes from the time
					 notified to respond.
5.
					 Neurological Surgery. The neurosurgeons on the pediatric trauma team must be
					 board certified. The pediatric neurosurgery liaison must maintain 48 hours of
					 trauma related CME over 3 years, and it is desirable to maintain current ATLS
					 certification. The pediatric neurosurgeon liaison to the pediatric trauma team
					 must attend a minimum of 50% of the peer review committees annually and
					 participate in the Multidisciplinary Trauma Committee. It is desirable to have
					 the neurosurgeon dedicated to the pediatric trauma center solely while on-call,
					 but if not dedicated, a published back-up call schedule must be available.
					 Response time for all trauma activations is 30 minutes from the time notified
					 to respond.
6. Anesthesia (in-house
					 24 hours/day). Anesthesia must be available with a mechanism established to
					 ensure early notification of the on-call anesthesiologist. Anesthesia must be
					 in-house and available 24 hours/day. Anesthesia chief residents or certified
					 nurse anesthetist (CRNA) may fill this requirement. When residents or CRNAs are
					 utilized, the staff anesthesiologist on-call will be advised, promptly
					 available, and present for all operations. Hospital policy must be established
					 to determine when the anesthesiologist must be immediately available for airway
					 control and assisting with resuscitation. The availability of the
					 anesthesiologist and the absence of delays in airway control or operative
					 anesthesia must be documented and monitored by the PI process. The maximum
					 response time for all trauma patients is 30 minutes from the time notified to
					 respond.
7. The following
					 specialists must be committed to pediatric trauma care, on-call and promptly
					 available 24 hours/day:
a. Cardiac
					 Surgery
b. Cardiology
c. Critical Care Medicine
d. Hand Surgery
e. Infectious Disease
f. Microvascular Surgery
g. Nephrology
h. Nutritional support
i. Obstetrics/Gynecologic Surgery
j. Ophthalmic Surgery
k. Oral/Maxillofacial
l. Pediatrics
m. Pediatric Critical Care Medicine
n. Pediatric Rehabilitation
o. Plastic Surgery
p. Pulmonary Medicine
q. Radiology
r. Thoracic Surgery*
s. Child Life or Family Support Programs
* The trauma surgeon is presumed to be qualified and have
						privileges to provide emergency thoracic surgical care to pediatric patients
						with thoracic injuries. If this is not the case, the facility should have a
						board-certified thoracic surgeon immediately available for the injured
						pediatric patient (within 30 minutes of the time notified to respond).