Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 3 - Level II Trauma Centers › Subchapter 2 - Clinical Components › Rule 15-12-32-3.2.1 - Required Components

Current through June 25, 2024
Level II Trauma Centers must maintain published call
						schedules and have the following physician coverage immediately available 24
						hours/day:
1. 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.
2. Trauma/General Surgery. The trauma surgeon
					 on-call must be unencumbered and immediately available to respond to the trauma
					 patient. The general surgeon is expected to be in the emergency department upon
					 arrival of the seriously injured patient. Hospital policy must be established
					 to define conditions requiring the trauma surgeon's presence with the clear
					 requirement on the part of the hospital and surgeon that the surgeon will
					 participate in the early care of the patient. The trauma surgeon's
					 participation in major therapeutic decisions, presence in the emergency
					 department for major resuscitation and presence at operative procedures is
					 mandatory. There must be a back-up surgeon schedule published. It is desirable
					 that the on-call surgeon be dedicated to the trauma center and not on-call to
					 any other hospital while on trauma call. A system must be developed to assure
					 early notification of the on-call to any other hospital while on trauma call. A
					 system must be developed to assure notification of the on-call surgeon and
					 compliance with these criteria and their appropriateness must be documented and
					 monitored by the PI process. Response time for Alpha Alert/Activations is 30
					 minutes and starts at patient arrival or EMS notification, whichever is
					 shorter. Response time for Bravo Alerts/Activations is 45 minutes from the time
					 notified to respond.
3. Orthopedic
					 Surgery. The orthopedic surgeons on the trauma team must be board certified. It
					 is desirable to have the orthopedists dedicated to the trauma center solely
					 while on-call or a back up schedule should be available. The maximum response
					 time for all trauma patients is 60 minutes from the time notified to
					 respond.
4. Neurologic Surgery. The
					 neurosurgeons on the trauma team must be board certified. It is desirable to
					 have the neurosurgeon dedicated to the trauma center solely while on-call or a
					 back up schedule should be available. The maximum response time for all trauma
					 patients is 30 minutes from the time notified to respond.
5. Anesthesia (In-house 24 hours/day)
					 Anesthesia must be immediately 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 Registered
					 Nurse Anesthetist (CRNAs) 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.
6. The following
					 specialists must be on-call and promptly available 24 hours/day:
a. Critical Care Medicine
b. Hand Surgery
c. Infectious Disease
d. Microvascular Surgery
e. Obstetrics/Gynecologic Surgery
f. Ophthalmic Surgery
g. Oral/Maxillofacial
h. Plastic Surgery
i. Radiology
j. Thoracic Surgery*
*A trauma surgeon is presumed to be qualified and have
						privileges to provide emergency thoracic surgical care to patients with
						thoracic injuries. If this is not the case, the facility should have a
						board-certified thoracic surgeon immediately available (within 30 minutes of
						the time notified to respond).