Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 32 - Trauma System › Chapter 2 - Level I Trauma Centers › Subchapter 2 - Clinical Components › Rule 15-12-32-2.2.1 - Required Components

Current through June 25, 2024
Level I 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 (In-house
					 24/hours). The trauma surgeon on-call must be unencumbered and immediately
					 available to respond to the 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. This may allow the attending
					 surgeon to take call from outside the hospital. 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. The surgeon on-call must 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 15 minutes and starts at patient arrival or EMS
					 notification, whichever is shorter. Response time for Bravo Alerts/Activations
					 is 20 minutes and starts at patient arrival or EMS notification, whichever is
					 shorter.
3. Orthopedic Surgery. 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. 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. 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. Plastic Surgery
n. Pulmonary Medicine
o. Radiology
p. 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 cardiac/thoracic surgeon immediately available (within 30
						minutes of the time notified to respond).