reglab/statecodes huggingface dataset:
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.08 - Pediatric Intensive Care Unit (PICU)

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospital shall have a separate PICU with the capability to care for all significantly injured children.
B. The PICU shall:
(1) Have appropriately trained registered nurse staff to care for the critically injured child to include:
(a) Brain injury;
(b) Spinal cord injury;
(c) Solid organ injury;
(d) Chest injury;
(e) Complex musculoskeletal injury;
(f) Burns;
(g) Eye injury;
(h) Hand and upper extremity injury; and
(i) Lower extremity injury;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.09 - General Pediatric Unit

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospital shall have a general pediatric unit, ideally a dedicated surgical unit to include trauma, adequately staffed 24 hours a day and equipped to care for all injured children.
B. The general pediatric unit shall:
(1) Have the equipment and capability to care for the child with multiple traumatic injuries;
(2) Have appropriately trained registered nursing staff to care for the multiply injured child;
(3) Be staffed at a level to ensure appropriate nurse-patient ratios as determined by written nursing standards;
(4) Have written plans for discharge and transfer of injured children to:
(a) Appropriate inpatient rehabilitation;
(b) Pediatric home care; and
(c) Outpatient follow-up; and
(5) Have the support services available for psychological support, rehabilitative therapy, and educational liaison with schools.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.10 - Radiological Specialty Capabilities

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital shall have:
A. Radiological specialty capabilities and equipment to handle all injured children;
B. Qualified pediatric radiologists and staff available within 60 minutes of consultation notification to perform complex imaging studies or interventional procedures 24 hours a day;
C. A board-certified or board-eligible radiology attending physician on call who shall provide interpretations of radiographs within 30 minutes, in house or via teleradiology, available 24 hours a day;
D. Changes in interpretation between preliminary and final reports, as well as missed injuries, monitored through the QM program;
E. In-house radiology technicians 24 hours a day;
F. Computed tomography (CT) scan with an in-house CT technician 24 hours a day;
G. Back-up CT scan capabilities;
H. Angiography;
I. Sonography;
J. Magnetic resonance imaging;
K. Nuclear scanning; and
L. Trans-esophageal echocardiography.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.11 - Rehabilitation Services

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital shall have:
A. Rehabilitation capabilities adequately staffed with equipment available to treat all injured children while in the pediatric trauma center;
B. Rehabilitation consultation services, occupational therapy, speech therapy, and physical therapy, available in the critical care phase as needed;
C. Pediatric rehabilitation services staffed by personnel trained in pediatric rehabilitation care and properly equipped for acute care of injured pediatric patients;
D. Full in-house service or transfer process in place to a rehabilitation service for long-term care or sub-acute care; and
E. Transfer agreements to rehabilitation hospitals, for the primary three rehabilitation hospitals the trauma center utilizes, which may be a joint transfer agreement if the trauma center is a part of a health system that utilizes a particular rehabilitation center.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.12 - Follow-Up Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospital shall have follow-up services adequately staffed and equipped to treat injured children.
B. Pediatric trauma clinic outpatient follow-up shall be available with coordination of the interdisciplinary team.
C. Pediatric surgical and medical subspecialty clinics shall be available for follow-up care.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.13 - Clinical Laboratory Service

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospital shall have clinical laboratory service available 24 hours a day, adequately staffed and immediately available and equipped for injured children.
B. The clinical laboratory service shall have the following services available:
(1) Stat lab capabilities;
(2) Standard analysis of blood, urine, and other body fluids;
(3) Blood-typing and cross match;
(4) Comprehensive blood bank or access to a central blood bank in the community and adequate storage facilities with stock minimums set by protocol for blood products;
(5) Blood gas analysis;
(6) Coagulation studies;
(7) Microbiology; and
(8) Toxicological screening.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.14 - Quality Management

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospital shall have ongoing QM of the pediatric trauma program that is integrated into the hospital's overall QM program and reported to the hospital's governing body.
B. The following shall be included in the pediatric QM program:
(1) A structure to ensure that defined program outcomes and performance measures are developed and monitored regularly;
(2) A special audit of all pediatric trauma deaths;
(3) Review of morbidity and mortality;
(4) Evaluation of medical care, nursing care, utilization review, tissue review, and prehospital care;
(5) Monthly review, at an appropriate interdisciplinary forum, of the performance of the pediatric trauma program, including:
(a) Trends;
(b) All deaths;
(c) All transfers;
(d) Morbidities;
(e) Problem identification and solution;
(f) Issues identified from the QM process; and
(g) System or administrative issues;
(6) Maintenance of minutes for all meetings in accordance with the hospital QM program;
(7) Requirements for designated liaisons (medical and nursing) to attend at least 50 percent of the trauma peer review meetings, and with supporting documentation;
(8) Requirements for all pediatric general surgeons who take pediatric trauma call to attend at least 50 percent of the trauma peer review meetings;
(9) Documentation of QM to demonstrate the interdisciplinary approach to the QM program, including:
(a) Problem identification;
(b) Analysis;
(c) Action planning;
(d) Implementation;
(e) Reevaluation; and
(f) Corrective action; and
(10) Monitoring of Level I Pediatric Trauma Center bypass status including "fly-by" and re-route events.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.15 - Injury Prevention and Public Education

Current through Register Vol. 51, No. 14, July 12, 2024
The level I pediatric trauma center shall:
A. Collaborate closely with MIEMSS and other State agencies in developing, monitoring, and evaluating the effectiveness of prevention and public education programs;
B. Conduct epidemiology research including studies in injury control;
C. Collaborate with other hospitals, MIEMSS, or other agencies in pediatric injury prevention initiatives and research;
D. Have an organized and effective approach to injury that prioritizes those efforts based on the Maryland State Trauma Registry (MSTR) and epidemiologic data;
E. Monitor progress of prevention programs in cooperation with State QM activities;
F. Have a designated prevention coordinator;
G. Have outreach and program development activities targeted to pediatric injury prevention within the region and State;
H. Have information resources for children and families; and
I. Collaborate with existing national, regional, and State programs.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.16 - Trauma Research

Current through Register Vol. 51, No. 14, July 12, 2024
The level I pediatric trauma center shall:
A. Have an organized pediatric trauma research program with a designated physician director and a documented research plan;
B. Hold regular meetings of the research group;
C. Show evidence of productivity;
D. Have research proposals reviewed by an institutional review board;
E. Conduct clinical research designed to enhance the trauma system's ability to resuscitate, stabilize, and treat trauma patients in the most cost-effective manner;
F. Present research study results at local, regional, and national meetings; and
G. Produce publications in peer-reviewed journals on an average of seven times per year.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.17 - Education

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital shall:
A. Assist MIEMSS with developing, monitoring, and evaluating the effectiveness of EMS training programs;
B. Offer and participate in formal pediatric trauma CE for hospital personnel and community health care clinicians;
C. Have a pediatric surgery fellowship program accredited by the Accreditation Council of Graduate Medical Education (ACGME);
D. Participate in a general surgical residency program accredited by the ACGME;
E. Participate in a pediatric emergency medicine fellowship program; and
F. Participate in undergraduate medical and nursing education.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.18 - Continuing Education (CE)

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospital shall provide and participate in periodic continuing education programs for physicians, nurses, and allied health personnel concerning the treatment and care of the pediatric trauma patient and family.
B. The hospital shall:
(1) Provide formal internal continuing education programs for physicians, nurses, and allied health professionals;
(2) Provide orientation on pediatric trauma protocols and trauma care for all rotating physicians, nurses, and allied health personnel assigned to units where pediatric trauma care is provided; and
(3) Provide external continuing education programs concerning the care and treatment of pediatric trauma patients for physicians, nurses, and allied health personnel within the region and in the State.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.19 - Policies, Protocols, and Agreements

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospital shall develop, distribute, and monitor implementation of the following patient treatment and care protocols:
(1) Pediatric resuscitation protocol;
(2) Procedural sedation protocols for children;
(3) Transfusion and massive transfusion protocol;
(4) Infection control protocol;
(5) Pediatric trauma resuscitation team activation protocol;
(6) Physician call schedule and notification protocol;
(7) Interhospital transfer protocol;
(8) Helicopter safety protocol;
(9) Organ procurement protocol;
(10) Child protection team protocol;
(11) Pediatric psychosocial care protocol; and
(12) Pediatric rehabilitation care protocol.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.20 - Trauma Program Manager

Current through Register Vol. 51, No. 14, July 12, 2024
A. There shall be a TPM who is a registered nurse responsible for the organization of services and systems necessary for a multidisciplinary approach to providing care to the injured patient in collaboration and conjunction with the TMD.
B. There shall be a defined organizational structure, which delineates the roles and responsibilities of the TPM.
C. The TPM shall be a 1.0 FTE position dedicated to the management of the pediatric trauma center.
D. The institution's organization shall define the structural role of the TPM to include responsibility, accountability, and authority.
E. The TPM shall:
(1) Have a job description developed by the hospital to reflect the role and responsibilities and identified on an organizational chart depicting the relationship between the TPM and other services, including the Department of Nursing;
(2) Attend and participate in local, state and national trauma-related activities, including but not limited to EMS community, state trauma-related committees and events, and national trauma-related activities and events;
(3) Show evidence of 16 hours of trauma-related CE a year, and, over a 2-year period, half of the CE hours shall be obtained outside the hospital and be recognized by a national accrediting body;
(4) As requested, participate in multidisciplinary trauma research;
(5) Have sufficient administrative and budgetary commitment in order to support the needs of the trauma center inclusive of clerical and clinical nursing personnel that help fulfill the needs of concurrent performance improvement, outreach, and injury prevention functions;
(6) Supervise the Trauma Registry staff and trauma clinical QM staff and have oversite for injury prevention and outreach; and
(7) With the TMD, have oversight and approval of internal trauma-related education programs.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.21 - Trauma Registry

Current through Register Vol. 51, No. 14, July 12, 2024
A. The Trauma Center shall maintain a pediatric Trauma Registry with participation in the MSTR.
B. The Trauma Registry shall include, at a minimum, all of the data elements compliant with the MSTR Data Dictionary for Pediatric Patients, including:
(1) Demographic data;
(2) Pre-hospital data;
(3) Process of acute care;
(4) Clinical data;
(5) Outcome data;
(6) Final anatomical diagnoses;
(7) Procedure codes;
(8) QM data;
(9) Standard report utilization; and
(10) Case inclusion criteria.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.08 - Pediatric Trauma Center Standards › Section 30.08.08.22 - Emergency Preparedness

Current through Register Vol. 51, No. 14, July 12, 2024
A. The trauma center shall have a hospital emergency preparedness or disaster plan described in the hospital's policy and procedure manual or equivalent.
B. The hospital disaster plan shall have a hazards vulnerability analysis to guide the response plan.
C. Hospital Incident Command System shall be used as a management system for incident command, planning, logistics, operations, and finance/administrative functions.
D. A tiered approach depending on the magnitude of the event and alternatives for care shall be identified.
E. The trauma center shall be represented on the hospital's emergency preparedness or disaster committee.
F. The trauma center hospital shall:
(1) Participate in local, state, or national disaster management meetings, plans, and exercises;
(2) Conduct hospital drills that test the hospital's disaster plan at least twice a year, including actual plan activations that can substitute for drills; and
(3) Have a written plan for supporting trauma center incident debriefing that is accessible to all staff members.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.09 - Eye Trauma Center Standards › Section 30.08.09.01 - Organization

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital shall:
A. Be designated by MIEMSS and approved by the EMS Board as a Level II, Level I, or PARC trauma center;
B. Have a board of directors' resolution that states its commitment to provide state-of-the-art optimal eye trauma care as part of the Statewide emergency medical system;
C. Have an organized eye trauma center with a medical director who has:
(1) Authority to run the eye trauma center; and
(2) Responsibility for:
(a) Clinical coordination of the eye trauma center;
(b) Quality management, and
(c) Participation in the State and regional EMS system quality management, education, and prevention activities; and
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.09 - Eye Trauma Center Standards › Section 30.08.09.02 - Medical Staff

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital shall have:
A. The following physician coverage:
(1) An ophthalmology fellow or ophthalmology resident in house 24 hours a day, to be at the bedside within 30 minutes for emergent consultation requests, with a board-certified or board-eligible ophthalmologist on call and available to be at the bedside within 60 minutes for emergent consultation requests; and
(2) A board-certified or board-eligible emergency medicine physician in house 24 hours a day for eye trauma triage, with a board-certified or board-eligible attending ophthalmologist on call and available be at the bedside within 60 minutes for emergent consultation; and
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.09 - Eye Trauma Center Standards › Section 30.08.09.03 - Nursing Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospital shall provide all nurses who care for patients in the eye trauma center with:
(1) Special education in ophthalmic emergencies and eye trauma care; and
(2) Specific orientation to eye trauma center procedures and protocols for ophthalmic emergencies.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.09 - Eye Trauma Center Standards › Section 30.08.09.04 - Facility

Current through Register Vol. 51, No. 14, July 12, 2024
A. Ophthalmic Treatment Area. The hospital shall have:
(1) An ophthalmic treatment area that is identified for and dedicated to the examination of ophthalmic emergencies;
(2) A medical director of the eye trauma center to oversee the management of the ophthalmic treatment area;
(3) A nurse manager responsible for the ophthalmic treatment area;
(4) Organized equipment and supplies to care for eye trauma, including:
(a) A slitlamp biomicroscope;
(b) An indirect ophthalmoscope;
(c) A visual acuity chart (that is, Snellen and near chart);
(d) Color plates, either Ishihara, or Hardy-Rand-Rittler;
(e) Applanation Tonometry (that is, Tonopen, iCare®); and
(f) Diagnostic ophthalmic lenses for gonioscopy and ophthalmoscopy;
(5) The following readily available medications necessary for the treatment and diagnosis of ophthalmic emergencies (in the event of regional or national drug shortages, pharmacy will assist with sourcing of appropriate, alternative options):
(a) Systemic eye pressure lowering medications;
(b) Topical intraocular pressure lowering medications of different classes;
(c) Mydriatic and cycloplegic drops;
(d) Topical anesthetics, such as proparacaine and tetracaine; and
(e) Fluorescein drops or strips;
(6) Sterile surgical sets specifically for ophthalmic trauma care readily available and located in the ophthalmic treatment area, including:
(a) Vitreous tap and inject equipment;
(b) Lateral canthotomy set;
(c) Ocular lavage set-up; and
(d) pH strips;
(7) Equipment for skin laceration repair;
(8) The following equipment:
(a) Laser iridotomy (YAG or Argon);
(b) Argon laser for retinopexy;
(c) Cryoprobe available for retinopexy; and
(d) Either of the following equipment for pneumatic retinopexy:
(i) SF6, or
(ii) C3 F8 gas; and
(e) Corneal foreign body removal equipment such as 27-30 gauge needle and corneal burr;
(9) Pharmacy support available to obtain intravitreal antimicrobial medications and steroids within 1 hour, 24 hours a day; and
(10) Pharmacy support available to obtain topical fortified antimicrobial medications within 1 hour, 24 hours a day.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.09 - Eye Trauma Center Standards › Section 30.08.09.05 - Quality Management

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital shall:
A. Have ongoing QM of the eye trauma center that is integrated into the hospital's overall QM program;
B. Participate in the State EMS system QM activities, as described in this subtitle;
C. Maintain an eye trauma registry;
D. Participate in and maintain the State eye trauma registry; and
E. Have QM activities, including:
(1) Problem identification,
(2) Problem analysis,
(3) Action planning;
(4) Implementation of the plan;
(5) Reevaluation of the plan; and
(6) Loop closure.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.09 - Eye Trauma Center Standards › Section 30.08.09.06 - Prevention and Public Education

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital shall:
A. Provide leadership and coordination for the development and implementation of prevention and public education programs for eye injuries; and
B. Monitor the progress of eye trauma prevention programs in cooperation with State quality monitoring activities.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.09 - Eye Trauma Center Standards › Section 30.08.09.07 - Research

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital shall:
A. Have an organized eye clinical research program with a documented research plan; and
B. Conduct research and submit to MIEMSS a summary of publications that may span topics of prevention, interventions, outcomes, or costs of treatment.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.09 - Eye Trauma Center Standards › Section 30.08.09.08 - Training

Current through Register Vol. 51, No. 14, July 12, 2024
The Eye Trauma Center shall develop and provide education and training concerning ophthalmic injuries for:
A. Physicians;
B. Nurses;
C. EMS clinicians; and
D. Other appropriate allied health personnel.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.10 - Neurotrauma Center Standards › Section 30.08.10.01 - Organization

Current through Register Vol. 51, No. 14, July 12, 2024
A neurotrauma center hospital shall:
A. Maintain a specialized unit dedicated to traumatic brain injury and spinal cord injury;
B. Be designated as Level 1 trauma center or PARC by MIEMSS;
C. Demonstrate both a medical and administrative commitment to the care of the neurotrauma patient by:
(1) Having a board of director's resolution stating:
(a) That the hospital agrees to meet the neurotrauma standards for designation; and
(b) The hospital's commitment to the infrastructure and the financial, human, and physical resources necessary to support the neurotrauma center;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.10 - Neurotrauma Center Standards › Section 30.08.10.02 - Neurotrauma Center

Current through Register Vol. 51, No. 14, July 12, 2024
A. A neurotrauma center shall:
(1) Participate in the Statewide trauma and specialty care system, including submission of patient care data to the State trauma registry for quality management; and
(2) Receive a minimum annual volume of 100 traumatic brain injured patients, spinal cord injured patients, or both.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.10 - Neurotrauma Center Standards › Section 30.08.10.03 - Neurotrauma Center Director

Current through Register Vol. 51, No. 14, July 12, 2024
A. A neurotrauma center shall have a director who provides oversight to all care for neurotrauma patients admitted to the center.
B. The neurotrauma center director shall meet the requirements in Regulation .05 of this chapter.
C. Responsibilities of the neurotrauma center director include:
(1) Creation of policies procedures, and protocols/guidelines for the neurotrauma center that specify the care of neurotrauma patients;
(2) Participation with the State EMS system in development of policies and protocols for use throughout the EMS system for initial care, triage, and transport of neuro-injured patients;
(3) Communication on a regular basis with physicians and other authorities regarding patients who have been referred;
(4) Direction of the neurotrauma center administrative functions in collaboration with Level I/PARC leadership;
(5) Direction and active participation in the neurotrauma quality management (QM) program; and
(6) Development of and participation in both internal and external continuing medical education (CME) programs in the care and prevention of neuro injuries.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.10 - Neurotrauma Center Standards › Section 30.08.10.04 - Medical Staff

Current through Register Vol. 51, No. 14, July 12, 2024
A. A neurotrauma center shall have the following team members:
(1) A Board-certified or board-eligible, in-house neurosurgery attending or PGY2 or higher, dedicated 24 hours a day to trauma care, with a neurosurgery attending on call who shall be at the patient bedside within 30 minutes after emergent consultation has been requested by the trauma team leader for injured patients based on institution-specific criteria;
(2) A trauma fellowship-trained general surgeon;
(3) A board-certified anesthesia attending;
(4) A board-certified orthopedic or neurosurgery spine attending surgeon or PGY2 or higher orthopedic or neurosurgery resident with an attending on call with a 30-minute response to the patient bedside;
(5) A board-certified or board-eligible trauma/critical care attending or critical care fellow with a trauma/critical care attending on call with a 30-minute response to the patient bedside; and
(6) An on-call schedule for residents, fellows, and attendings who are assigned to the neurotrauma center.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.10 - Neurotrauma Center Standards › Section 30.08.10.05 - Qualifications for Neurotrauma Surgeons

Current through Register Vol. 51, No. 14, July 12, 2024
Category/Description
Director
Staff Surgeons
A. Certification. All neurosurgeons shall be board-certified or board-eligible in neurosurgery. A qualified Neurosurgeon shall be regularly involved in the care of patients with neurologic injuries and shall be credentialed by the hospital with general neurosurgical privileges.
Required
Required
B. Continuing Medical Education. The CME qualification requires annual participation in at least 16 hours or more of trauma or neurotrauma related CME per year.
Required
Required
C. Research Participation. The research participation qualification is to demonstrate a commitment to clinical or basic science neurotrauma care which can be met by:
Required
Desirable
(1) Annual submission of an abstract or publication related to neuro injuries; or
(2) Research projects in progress.
D. Community Education and Neurotrauma Injury Prevention. The community education and neurotrauma injury prevention qualification is to participate in:
Required
Desirable
(1) The development or revision of community or EMS neurotruama treatment protocols, or representation on a State or local EMS committee; and
(2) At least one of the following:
(a) Annual participation in one or more prehospital training/certification courses in neurotrauma care which can be met by prehospital basic life support or advanced life support courses or equivalent courses;
(b) Annual development or presentation of neurotrauma care courses or lectures which can be met by prehospital basic life support or advance life support courses or equivalent courses; or
(c) Participation in a neurotrauma injury prevention program.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.10 - Neurotrauma Center Standards › Section 30.08.10.06 - Nursing Personnel

Current through Register Vol. 51, No. 14, July 12, 2024
A. A neurotrauma center shall have:
(1) A nurse manager who is administratively responsible for the center;
(2) An organizational chart relating the nurse manager to other members of the neurotrauma center and the hospital; and
(3) A masters-prepared advanced practice nurse with clinical expertise in neurotrauma care with responsibility for clinical nursing oversight and nursing staff consultation.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.10 - Neurotrauma Center Standards › Section 30.08.10.07 - Facility and Equipment

Current through Register Vol. 51, No. 14, July 12, 2024
A neurotrauma center shall have:
A. For emergency resuscitation:
(1) Immediate access to a computed tomography (CT) scanner; and
(2) Intracranial Pressure (ICP) monitoring equipment;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.10 - Neurotrauma Center Standards › Section 30.08.10.08 - Inpatient Acute Care Rehabilitation Program

Current through Register Vol. 51, No. 14, July 12, 2024
A neurotrauma center shall:
A. Have a rehabilitation program that is designed for neurotrauma patients and directed by a board-certified physiatrist;
B. Meet rehabilitation requirements as follows:
(1) Rehabilitation services staffed by personnel trained in rehabilitative care and properly equipped for acute care of the traumatic brain injured or spinal cord injured patient; and
(2) Rehabilitation consultation services, appropriately licensed or registered in their specific disciplines (that is, occupational therapy, speech therapy, physical therapy, and social services), available in the critical care phase as needed;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.10 - Neurotrauma Center Standards › Section 30.08.10.09 - Neurotrauma Rehabilitation.

Current through Register Vol. 51, No. 14, July 12, 2024
A neurotrauma center shall have:
A. Transfer agreements to rehabilitation hospitals, for the primary three rehabilitation hospitals the trauma center utilizes, which may be joint transfer agreements if the trauma center is a part of a health system that utilizes a particular rehabilitation center with appropriate services tailored to the needs of traumatic brain and spinal cord injured patients;
B. A referral process/case management plan for timely assessment for, and placement in, an appropriate rehabilitation program;
C. Full in-house service or transfer process in place to a rehabilitation service for acute care or sub-acute care; and
D. Ongoing continuity of care for patients with traumatic brain and spinal cord injuries provided in affiliated rehabilitation acute or sub-acute facilities, by attending neurotrauma center specialists and sub-specialists.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.10 - Neurotrauma Center Standards › Section 30.08.10.10 - Quality Management Program

Current through Register Vol. 51, No. 14, July 12, 2024
A. A neurotrauma center shall have an ongoing QM program that is multidisciplinary and coordinated with the trauma QM program.
B. The neurotrauma center director is responsible for the QM program for neurotrauma patients.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.10 - Neurotrauma Center Standards › Section 30.08.10.11 - Research

Current through Register Vol. 51, No. 14, July 12, 2024
A neurotrauma center shall have:
A. An organized neurotrauma research program and a documented research plan;
B. Evidence of productivity through peer-reviewed publications;
C. Proposals reviewed by an institutional review board;
D. Presentations at local, regional, or national meetings;
E. Publications in peer-reviewed journals on an average of six per year; and
F. Clinical research trials designed to enhance the trauma system's ability to resuscitate, stabilize, and treat neurotrauma patients in the most cost-effective manner.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.10 - Neurotrauma Center Standards › Section 30.08.10.12 - Education

Current through Register Vol. 51, No. 14, July 12, 2024
A neurotrauma center shall:
A. Provide outreach education to health care providers throughout the State related to current standards of care for neurotrauma patients;
B. Participate in an ACGME-approved program for neurosurgical residency training;
C. Serve as a clinical site for education for health care providers; and
D. Participate in professional continuing education programs and professional meetings.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.10 - Neurotrauma Center Standards › Section 30.08.10.13 - Policies, Protocols, and Agreements

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital shall have patient treatment and care documents as specified in COMAR 30.08.05.19 with the addition of:
A. Resuscitation and treatment protocols/guidelines for traumatic brain injury; and
B. Resuscitation and treatment protocols/guidelines for spinal cord injury.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.11 - Designated Primary Stroke Center Standards › Section 30.08.11.01 - Designated Primary Stroke Center

Current through Register Vol. 51, No. 14, July 12, 2024
A designated primary stroke center hospital shall:
A. Be licensed as an acute care hospital by the hospital licensing authority in the jurisdiction in which it is located;
B. Be a hospital accredited by The Joint Commission;
C. If located in Maryland, be a base station approved under COMAR 30.03.06;
D. Provide assessment and management of the stroke patient consistent with the most current AHA/ASA consensus based clinical practice guidelines to meet the needs of the patient;
E. Have a stroke center medical director;
F. Have a dedicated stroke center nurse coordinator;
G. Have sufficient personnel and resources needed to facilitate healthcare data management and concurrent review of quality metrics and program objectives;
H. Meet the requirements of Regulations .03-.14 of this chapter;
I. Satisfy the MIEMSS requirements for designation as a primary stroke center; and
J. Meet the requirements for a site review in COMAR 30.08.02.06, which may be satisfied by completing either:
(1) An on-site review by MIEMSS; or
(2) A site survey as part of The Joint Commission Disease Specific Care Certification Program for certification as a primary stroke center if the hospital:
(a) Authorizes The Joint Commission to provide MIEMSS with survey findings, certification reports, and other information related to The Joint Commission;
(b) Allows MIEMSS to participate in the accreditation site survey; and
(c) Provides MIEMSS any additional information required to determine it has satisfied the requirements for designation under this chapter.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.11 - Designated Primary Stroke Center Standards › Section 30.08.11.02 - Organization

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital's board of directors, administrators, and medical and nursing staffs shall demonstrate commitment to the hospital's designation as a primary stroke center by:
A. A board of directors' resolution stating that the hospital agrees to meet the standards of this chapter for designation as a primary stroke center;
B. An organizational chart showing key stroke center personnel including the stroke center medical director and stroke center nurse coordinator and their relationship within the hospital;
C. Establishing mechanisms to guide and assure cooperative relationships with community and professional groups committed to increasing public awareness and improving acute stroke care;
D. Maintaining documentation of stroke center leadership including:
(1) An appointment letter for the stroke center medical director; and
(2) Curricula vitae of key stroke program personnel with training and expertise in cerebrovascular disease including:
(a) Physicians;
(b) A stroke center nurse coordinator; and
(c) Other key health care personnel; and
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.11 - Designated Primary Stroke Center Standards › Section 30.08.11.03 - Emergency Department

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital shall maintain an emergency department which:
A. Has written documentation on the process used to notify the stroke team of a patient with an acute stroke; and
B. Has sufficient emergency department clinical staff to meet the requirements of Regulation .05. of this chapter.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.11 - Designated Primary Stroke Center Standards › Section 30.08.11.04 - Operating Room

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital shall have:
A. Operating room neurosurgical services available 24 hours a day with appropriately trained support staff, and:
(1) Necessary equipment and tools to aid in the care of acute stroke patients including equipment necessary for continuous hemodynamic monitoring; and
(2) A written plan for neurosurgical procedures or evaluations to be performed within 2 hours of the determination they are clinically necessary which is approved by:
(a) The neurosurgeons providing coverage; and
(b) The stroke center medical director; or
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.11 - Designated Primary Stroke Center Standards › Section 30.08.11.05 - Stroke Team

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospital shall establish one or more acute stroke teams which shall respond to the emergency department with coordinated services for the effective delivery of emergency and acute stroke treatment.
B. Presence at Bedside.
(1) A member of the emergency department clinical staff shall evaluate each patient with stroke-like symptoms within 10 minutes of the patient's arrival at the emergency department.
(2) At least one member of the acute stroke team shall be present at the patient's bedside to provide care and to treat an acute stroke patient within 15 minutes of notification.
(3) The National Institutes of Health Stroke Scale (NIHSS) shall be used for the initial and serial assessment of patients with acute stroke. Clinicians performing an NIHSS will have documented training in the completion of the NIHSS.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.11 - Designated Primary Stroke Center Standards › Section 30.08.11.06 - Transfer of Stroke Patients in Need of Higher Level of Care

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital shall:
A. Transfer the clinically appropriate stroke patient requiring a higher level of care after initial treatment and stabilization to a MIEMSS designated primary stroke center that has endovascular capability or a MIEMSS designated comprehensive stroke center; and
B. Maintain an agreement or agreements with a commercial ambulance service to:
(1) Transfer stroke patients as clinically necessary;
(2) Ensure the appropriate delivery of care during transport; and
(3) Limit utilization of local emergency medical services (EMS) resources unless by pre-existing agreement.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.11 - Designated Primary Stroke Center Standards › Section 30.08.11.07 - Stroke Unit

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital shall maintain a stroke unit that meets the requirements of this regulation which:
A. Has designated beds for the care of acute stroke patients beyond the acute treatment period;
B. Provides care to acute stroke patients through qualified clinical staff who meet the requirements in Regulation .09 of this chapter;
C. Develops a standardized process originating in clinical practice guidelines or evidence-based practice to deliver or facilitate the delivery of clinical care;
D. Develops an individualized plan of care that is based on the patient's assessed needs and reflects coordination of care with other programs as determined by patient comorbidities; and
E. Maintains written documentation delineating the function of the stroke unit including:
(1) Admission criteria;
(2) Discharge criteria;
(3) Acute stroke care protocols;
(4) Interdisciplinary rounding;
(5) Patient census;
(6) Rehabilitation in the hospital;
(7) Rehabilitation after discharge; and
(8) Outcomes data.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.11 - Designated Primary Stroke Center Standards › Section 30.08.11.08 - Laboratory/Diagnostic Services

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital shall have the ability 24 hours a day to perform laboratory and diagnostic services within 45 minutes of written order including, but not limited to:
A. A complete blood count;
B. Blood chemistries;
C. Coagulation studies;
D. Troponin;
E. Electrocardiograms; and
F. Chest radiographs.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.11 - Designated Primary Stroke Center Standards › Section 30.08.11.09 - Neuroimaging Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospital shall have the ability 24 hours a day, within 20 minutes of the patient's arrival, to complete:
(1) All of the following:
(a) Brain computed tomography;
(b) CT Angiography; and
(c) CT Perfusion; or
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.11 - Designated Primary Stroke Center Standards › Section 30.08.11.10 - Qualifications of Stroke Center Director and Clinicians

Current through Register Vol. 51, No. 14, July 12, 2024
A. The stroke center medical director shall be a physician with special competence in caring for the acute stroke patient who is Board certified or Board eligible in:
(1) Neurology;
(2) Emergency medicine;
(3) Neurosurgery;
(4) Neuro interventional radiology; or
(5) Internal medicine.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.11 - Designated Primary Stroke Center Standards › Section 30.08.11.11 - Qualifications of Emergency Department Clinical Staff

Current through Register Vol. 51, No. 14, July 12, 2024
A. Emergency department clinical staff shall participate in cerebrovascular disease educational activities at least two times a year if they:
(1) Triage patients in the emergency department; or
(2) Care for acute stroke patients.