New Mexico Administrative Code › Title 7 - HEALTH › Chapter 27 - EMERGENCY MEDICAL SERVICES › Part 7 - TRAUMA CARE SYSTEM › Section 7.27.7.15 - APPENDIX D TABLE 1

Current through Register Vol. 35, No. 13, July 16, 2024
STATE OF NEW MEXICO
Trauma Care System Regulations/ Standards for Designation
Organization/ Management
(E) Essential (D) Desirable (N/A) Not Applicable
Level III
Level IV
(1) A Trauma Center must demonstrate
						  substantial medical, administrative and financial commitment for the level of
						  designation requested. Commitment must be demonstrated and include
						  documentation from hospital's:
a. Board of Directors;
E
E
b. Medical Staff; and
E
E
c. Administrative team.
E
E
(2) For the purpose of administrating trauma
						  care, a designated Trauma Center shall have a trauma program. The trauma
						  program includes a management team, which oversees the trauma program. The
						  trauma program shall:
a. Be organized and directed by a trauma
						  program medical director who is proficient in, and committed to the care of the
						  injured. The trauma program medical director shall be:
(i) Board certified or eligible in general surgery, or
						  other surgical specialties or emergency medicine as justified by the applicant
						  and approved by the State.
E
E
(ii) With training in trauma services and care.
D
D
(iii) Responsible for overall clinical direction,
						  management and administration of the hospital's trauma program.
E
D
(iv) Currently certified in ATLS (Advanced Trauma Life
						  Support)
E
E
(v) Demonstrate a commitment to trauma research; and
D
D
(vi) Must agree to actively participate in a defined
						  trauma related continuing education program on an annual basis.
E
D
b. Define a program for providing care to the trauma
						  patient to include coordination with the departments of surgery and emergency
						  medicine and other hospital departments.
E
E
c. Provide ongoing coordination of the
						  trauma program by a Trauma Nurse Coordinator who:
(i) In collaboration with the trauma program
						  medical director, monitors and coordinates trauma programs and system elements,
						  including:
(A) Clinical Activities;
E
E
(B) Trauma education and prevention activities;
E
E
(C) Research;
D
D
(D) Management activities per hospital needs;
E
E
(E) Trauma Registry; and
E
E
(F) Quality Improvement
E
E
(ii) Is a full-time position
E
D
(iii) Is licensed in State of New Mexico as a Registered
						  Nurse
E
E
(iv) Has appropriate resources/staff to meet the
						  requirements of these regulations and commitments of the hospital.
E
E
(v) Has demonstrated expertise in trauma
						  care as identified by a minimum of 5 years recent nursing experience in one of
						  the following areas:
(A) Trauma systems/care
D
D
(B) Emergency department
D
D
(C) Critical Care
D
D
(D) Trauma Program
D
D
(vi) Minimum current/continuing education:
(A) 5 hours/year trauma
E
E
(B) 2 hours/year pediatric
E
E
(C) TNCC (Trauma Nurse Core Curriculum) or equivalent
E
E
(vii) Participates in the development, implementation or
						  continuation of trauma care systems at their appropriate ReTrAC (Regional
						  Trauma Advisory Council)
E
E
d. Provide a multidisciplinary trauma
						  committee, which provides input to the trauma program and to hospital
						  administration as needed. The Trauma Committee shall demonstrate coordination
						  between the Departments of Surgery and Emergency Medicine and be responsible
						  for, but not limited to, the trauma program's Process Improvement process.
						  Membership shall include:
(i) An emergency physician;
E
E
(ii) Trauma medical director;
E
D
(iii) A neurosurgeon;
D
D
(iv) An orthopedic surgeon;
D
D
(v) A pediatrician;
D
D
(vi) An anesthesiologist/CRNA;
D
D
(vii) The trauma rehabilitation coordinator, trauma
						  social worker and discharge planner; and input from physiatrist; (if available)
D
D
(viii) Trauma Nurse Coordinator;
E
E
(ix) Other appropriate nursing disciplines;
E
E
(x) Radiology; and
D
D
(xi) Administration.
E
D
e. Include a trauma resuscitation team which
						  shall be;
(i) Directed by an emergency medical physician who is
						  proficient in the care of the injured, and who assumes responsibility for the
						  overall care and coordination of the trauma patient until the care is formally
						  turned over to the trauma/general surgeon (as appropriate per Level of
						  designation)
E
N/A
(ii) The team shall be organized and directed by an
						  in-house ED physician
E
D
(iii) All members of the team shall be promptly
						  available upon notification. (Trauma PI process must verify prompt
						  availability, outcome driven)
E
D
(iv) The trauma resuscitation team shall be activated in
						  accordance with the hospital's trauma program and consistent with the regional
						  trauma plan.
E
E
(v) Members of the trauma team shall:
(A) Be oriented to the trauma care system;
E
D
(B) Participate in the trauma PI (Performance/Process
						  Improvement) program;
E
D
(C) Participate in ongoing CME/CE in trauma;
E
D
(D) Be oriented to the internal trauma patient clinical
						  management system at the hospital;
E
E
(E) Be oriented to the trauma program policies and
						  procedures to include all operations of the trauma program including internal
						  written triage, treatment and transfer protocols and procedures to identify
						  which patients are triaged in and out of trauma program's clinical service.
E
E
(3) A Trauma Center shall have an Emergency Department
						  with established standards and procedures to ensure immediate and appropriate
						  care for the adult and pediatric trauma patients and a designated trauma
						  resuscitation and treatment space with the capacity to meet the needs of the
						  expected volume.
E
E
(4) A Trauma Center shall have a surgery
						  department, including:
a. General surgery on call and promptly available as
						  requested.
E
D
b. Trauma/general surgeons must be Board certified or
						  eligible in general surgery.
E
D
c. Trauma/general surgeons must have received ATLS
						  (Advanced Trauma Life Support) once in their career (note: if surgeon is
						  available)
E
E
d. A minimum of 6 hours per year or 18 hours over a
						  three year period of continuing education related to trauma. (note: if surgeon
						  is available)
E
E
e. Neurosurgery, Board certified and promptly available
						  on-call.
D
N/A
f. The following surgical services on-call
						  and available promptly:
(i) Gynecological surgery;
D
D
(ii) Hand surgery;
D
D
(iii) Microsurgery;
D
D
(iv) Obstetric surgery;
D
D
(v) Orthopedic surgery;
D
D
(vi) Otorhinolaryngologic/maxillofacial surgery and
						  capable of managing upper airway trauma;
D
D
(vii) Plastic surgery;
D
D
(viii) Thoracic surgery; and
D
D
(ix) Urologic surgery;
D
D
(x) General surgery for trauma service backup.
D
D
(xi) Pediatric surgeon available for consultation.
D
D
(5) A Trauma Center shall have other
						  specialties including:
a. Anesthesiology, with an anesthesiologist or CRNA who
						  is on-call and promptly available and current in ACLS (Advanced Cardiac Life
						  Support).
E
D
b. The following services on-call and
						  available promptly:
(i) Cardiology;
D
D
(ii) Gastroenterology;
D
D
(iii) Hematology;
D
D
(iv) Internal medicine;
E
D
(v) Nephrology;
D
D
(vi) Pathology;
D
D
(vii) Pediatrics;
E
D
(viii) Pulmonology/Intensivist
D
D
(ix) Psychiatry; and
D
N/A
(x) Radiology.
E
D
c. Other physician specialists on-call and available to
						  the trauma as defined by their protocols.
E
D
Note: Internal Trauma PI process must verify
						  "promptly" available services; outcome driven
(6) A Trauma Center shall have approved policies to
						  divert/redistribute and transfer patients to other designated facilities, based
						  on it's ability each patient at a particular time and collaborative work with
						  their respective ReTrAC.
E
E
(7) A Trauma Center shall
a. Have a PI program, which includes quality improvement
						  principals and an outcome orientation as provided for in this chapter.
E
E
b. Participate in regional trauma PI programs via their
						  respective ReTrAC
E
E
Resources and
						  Capabilities/Interhospital Transfer Guidelines
(1) A Trauma Center shall have an Emergency
						  Department with:
a. A physician director who is:
(i) Board certified or eligible in emergency medicine;
						  and/or
D
D
(ii) If not Board certified in emergency
						  medicine;
(A) Current with ATLS and PALS (Pediatric Advanced Life
						  Support)
E
E
(B) Must have 5 years or 7,000 hours experience in
						  emergency medicine
E
D
b. Emergency physicians;
(i) With 50% Board certified or eligible in emergency
						  medicine, with the remainder practicing emergency medicine as their primary
						  practice with special competency in the care of trauma patients and Board
						  certified in pediatrics, family practice, internal medicine, or general
						  surgery.
D
D
(ii) In-house and immediately available upon the
						  patient's arrival to the ED.
E
D
(iii) If not emergency medicine Board
						  certified:
(A) Current with ATLS;
E
E
(B) Current with PALS; or
E
E
(iv) If not Board certified in any of the
						  above specialties, they must be/have;
(A) Current with ATLS;
E
E
(B) Current with PALS; and
E
E
(C) Five (5) years or seven thousand (7,000) hours
						  experience in emergency medicine.
E
D
(v) A minimum of 6 hours per year or 18 hours over a
						  three year period of continuing education related to trauma.
E
E
(vi) Must have had ATLS once in their career
E
E
c. Trauma resuscitation/ED nurses:
(i) In the ED 24 hours per day
E
D
(A) At least two trauma resuscitation nurses
D
D
(B) At least one trauma-trained nurse
E
D
(ii) Currently RN licensed;
E
E
(iii) TNCC provider verification or an approved
						  equivalent;
E
E
(iv) Orientation to their nurse role (trauma
						  resuscitation nurse)
E
D
(v) Participates in a formal trauma PI program by
						  representation;
E
D
(vi) Minimum of 6 hours per year continuing education
						  related to trauma which may include credit for the TNCC;
E
E
(vii) Collaborates with health care professional and
						  families in donor identification and care, the organ and tissue procurement
						  process and recipient care.
E
E
d. An ED nurse manager
(i) Is currently RN licensed;
E
E
(ii) TNCC provider verification or an approved
						  equivalent;
D, Note
D, Note
(iii) Participates in a formal trauma PI program;
E
D
(iv) Minimum of 6 hours per year continuing education
						  related to trauma which may include TNCC
E
D
Note: The ED nurse manager who routinely
						  staffs to provide patient care, shall meet the requirements of the trauma
						  resuscitation/ED nurse (as described above)
e. Equipment for resuscitation and life
						  support of adult trauma patients, including:
(i) Airway control and ventilation equipment
						  including:
(A) Airways;
E
E
(B) Laryngoscopes, including curved and straight;
E
E
(C) Endotracheal tubes of all sizes;
E
E
(D) Bag-valve mask resuscitator, with full range of mask
						  sizes
E
E
(E) Sources of oxygen;
E
E
(F) Mechanical ventilation;
E
E
(ii) Suction devices, including:
(A) Back-up suction source;
E
E
(B) Suction catheters; and
E
E
(C) Tonsil suction tip.
E
E
(iii) Electrocardiograph;
E
E
(iv) Cardiac monitor;
E
E
(v) Defibrillator, including internal and external
						  paddles;
E
D N/A for internal paddles
(vi) All standard apparatus to establish central venous
						  pressure monitoring;
E
E
(vii) All standard intravenous fluids and administering
						  devices
E
E
(viii) Sterile surgical sets for procedures standard for
						  ED trauma care such as thoracotomy, vascular access, chest decompression;
E
D
(ix) Gastric lavage equipment;
E
E
(x) Drugs and supplies necessary for emergency care;
E
E
(xi) Capability for the rapid infusion of fluids;
E
E
(xii) Capability for rapid fluid recovery and
						  transfusion;
E
E
(xiii) Thermal control equipment for;
(A) Patient;
E
E
(B) Blood;
E
E
(xiv) Two-way radio linked with prehospital vehicles;
E
E
(xv) Cervical injury immobilization devices;
E
E
(xvi) Long-bone stabilization devices.
E
E
f. Trauma social services or crisis intervention
						  services based on an approved hospital protocol.
D
D
(2) A Trauma center shall have an Operating
						  Room (OR) that:
a. Assures prompt availability of an OR suite 24 hours
						  per day; and
E
D
b. Staffs with at least one RN in-house for the
						  anticipated volume of patients and the remainder of the OR team and support
						  staff on-call and promptly available.
D
D
c. Has OR nurses who:
(i) Are currently licensed as RNs;
E
E
(ii) Can demonstrate trauma preparedness for the care of
						  the trauma patient in the OR through hospital approved competencies and/or
						  formal training course;
E
D
(iii) Complete a structured orientation program related
						  to the perioperative care of the trauma patient;
E
D
(iv) Minimum of 6 hours per year continuing education
						  related to the perioperative care of the trauma patient;
E
D
(v) Participates in the multidisciplinary trauma
						  committee by representation including patient care conferences;
E
E
(vi) Participates in trauma PI activities by
						  representation.
E
E
d. Has a documented method for prompt mobilization of
						  consecutive surgical teams for trauma patients;
E
D
e. Collaborates with health professionals and families
						  in donor identification and care, the organ and tissue procurement process and
						  recipient care.
E
E
f. Includes equipment or capabilities
						  including;
(i) Cardiopulmonary bypass;
D
D
(ii) Operating microscope;
D
N/A
(iii) Thermal control equipment for patients;
E
E
(iv) Thermal control for blood;
E
E
(v) Rapid infusion capability;
E
E
(vi) Rapid fluid recovery capability;
E
D
(vii) Radiology capability;
E
E
(viii) Bronchoscope in operating room;
E
D
(ix) Endoscopes available
E
D
(x) Monitoring equipment; and
E
E
(xi) Instruments for external and internal fixation of
						  fractures;
D
D
(xii) Instruments and equipment appropriate for
						  pediatric trauma care;
D
D
g. Designated operative treatment space with the
						  capacity to meet the needs of the expected patient volume.
E
D
(3) A Trauma Center shall have a
						  post-anesthesia care unit or an acceptable surgical intensive care unit
						  designated for surgical patient recovery with:
a. Essential personnel, including at least one nurse
						  with critical care and post-anesthesia care training, readily available 24
						  hours a day;
E
D
b. Can demonstrate trauma preparedness for the care of
						  the post-anesthesia trauma patient through approved competencies and/or formal
						  training courses;
E
D
c. Completes a structured orientation program related to
						  the post-anesthesia perioperative care of the trauma patient;
E
D
d. Appropriate monitoring and resuscitative equipment.
E
D
(4) A Trauma Center shall have an intensive
						  care unit (ICU) with:
a. A medical director who is Board certified or eligible
						  in critical care, internal medicine, pulmonary medicine, cardiology, or
						  surgery;
E
D
b. A physician on duty in the ICU 24 hours a day, or who
						  is immediately available; Note: May be met by an ED physician meeting the
						  requirements of these regulations
E
D
c. A physician-directed code team;
E
D
d. Intensive care registered nurses who:
(i) Are currently RN licensed;
E
D
(ii) TNCC verified or an equivalent course;
E
D
(iii) Completes a structured orientation and competency
						  program which includes content related to the care of a trauma patient;
E
D
(iv) Minimum of 6 hours per year continuing education
						  related to trauma;
E
D
(v) Participates in a multidisciplinary trauma committee
						  including patient-care conferences by representation;
E
D
(vi) Participates in trauma PI activities;
E
D
(vii) Collaborates with health care professionals and
						  families in donor identification and care, the organ and tissue procurement and
						  recipient care.
E
E
e. Equipment appropriate for adult
						  including:
(i) Airway control and ventilation devices;
E
E
(ii) Oxygen source with concentration controls;
E
E
(iii) Cardiac emergency cart;
E
E
(iv) Temporary pacemaker;
E
D
(v) Electrocardiograph-cardiac monitor-defibrillator;
E
E
(vi) Cardiac output monitoring;
D
D
(vii) Electronic pressure monitoring
D
D
(viii) Mechanical ventilator devices;
E
D
(ix) Patient weighing devices;
E
E
(x) Pulmonary function measuring devices;
D
D
(xi) Temperature control devices;
E
D
(xii) Drugs, intravenous fluids, and supplies; and
E
E
(xiii) Intracranial pressure monitoring devices.
D
D
f. Designated trauma critical care and treatment space
						  with the capacity to meet the needs of the expected patient volume.
E
D
(5) A Trauma Center shall have a clinical
						  laboratory immediately available based upon the expected volume of patients,
						  including:
a. Standard analysis of blood, urine, and other body
						  fluids;
E, Note
E, Note
b. Coagulation studies;
E, Note
E, Note
c. Blood gases and pH determination;
E, Note
E, Note
d. Serum and urine osmolality;
E, Note
D
e. Microbiology;
E, Note
D
f. Alcohol determination;
E, Note
D
g. Drug screening; and
D
D
h. Microtechnique.
E, Note
D
Note: Shall be promptly available
(6) A Trauma Center shall have transfusion
						  services including:
a. Blood and blood components available from in-house or
						  through community services, to meet patient needs in a timely fashion;
E
D
b. Ability to have non-crossmatched blood available on
						  patient arrival to the ED;
E
D
c. Procedures and ability to perform massive
						  transfusions and autotransfusion; and
E
D
d. Blood storage capability;
E
D
(7) A Trauma Center shall have radiological
						  services including:
a. The following services in-house and
						  immediately available:
(i) Computerized tomography
E, Note
D
Note: Shall be promptly available
(ii) Radiology capability;
E, Note
E, Note
Note: If not in-house 24 hours per day, must
						  have an approved early notification process
(iii) In-house CT technician 24 hours a day
E, Note
D
Note: Shall be promptly available
(iv) In-house radiology technician 24 hours a day
E, Note
D
Note: Shall be promptly available
Note: Trauma PI process must verify promptly
						  available services, outcome driven
b. The following services on-call and
						  promptly available:
(i) Angiography
D
D
(ii) Sonography
D
D
(8) A Trauma Center shall have acute dialysis
						  capability, or a written agreement with an appropriate facility for such.
E
E
(9) A Trauma Center shall have:
a. A physician-directed burn unit which is staffed by
						  nursing personnel trained in burn care and is equipped to care for extensively
						  burned patients; and/or
D
D
b. Written transfer agreement with a burn center or
						  hospital with a burn unit.
E
E
(10) A Trauma Center shall be able to manage Traumatic
						  Brain Injury and/or spinal cord injury; or have written transfer agreements
						  with a facility with such capabilities. Adherence to current management
						  guidelines shall be considered.
E
E
(11) A Trauma Center shall have a designated trauma
						  rehabilitation coordinator.
D
D
(12) A Trauma Center shall have:
a. A physician-directed rehabilitation medicine service
						  which is staffed by personnel trained in rehabilitation care and is equipped to
						  care for the trauma patient and/or;
D
D
b. Written agreements to transfer patients to a
						  designated rehabilitation service when medically feasible.
E
E
(13) A Trauma Center shall have a heliport or helipad
						  meeting applicable standards and any applicable Department-approved procedures
						  and located close enough to permit the facility to receive and transfer
						  patients by air.
E, Note
E, Note
Note: May be fulfilled through a designated
						  landing site with supporting written protocols.
(14) In addition to all transfer agreements
						  in this section, designated Trauma Centers shall have additional written
						  transfer agreements for the identification and transfer of patients with
						  special care needs who meet inter-hospital transfer criteria, to include the
						  following patients categories:
a. Pediatrics
E
E
b. Obstetrics
E
E
c. Other considerations based upon the specific hospital
						  needs
E
E
(15) Transfer agreements shall include the
						  responsibility of the transferring hospital and the receiving hospital, and
						  shall assign medical control during inter-hospital transfer.
E
E
(16) Transferring facilities shall use
						  Department-approved pre-hospital services for inter-facility transfer of trauma
						  patients.
E
E
Outreach, Training, and Public
						  Education
(1) A Trauma Center shall have:
a. An outreach consultation and referral program with
						  physicians of the community, prehospital care agencies and outlying areas
						  regarding trauma care developed through participation with their respective
						  ReTrAC.
E
E
b. An outreach program with other designated trauma
						  centers and hospitals developed through participation with their respective
						  ReTrAC to include:
E
E
(i) Agreement to participate in regional trauma
						  monitoring and PI meetings as defined by the State IPEMS Bureau;
E
E
(ii) Monitoring of the transfers in and out of the
						  designated trauma center;
E
E
(iii) Establishing transfer agreements and referral
						  feedback mechanisms.
E
E
c. Training, including;
(i) Offers or participates in a formal
						  program of continuing trauma care education for:
(A) Staff and community physicians;
E
E
(B) Staff and community nurses;
E
E
(C) System and trauma clinical training for all allied
						  health care professionals throughout the continuum;
E
D
(D) Prehospital personnel;
E
D
(ii) Hospital to cooperate and make available initial
						  and maintenance training of invasive skills for prehospital personnel.
E
D
d. A public awareness/education program,
						  developed through collaboration with their respective ReTrAC addressing:
(i) Injury prevention and wellness issues relevant to
						  the region;
E
E
(ii) Problems confronting the medical and nursing
						  professions including hospitals regarding; hospital diversion, ED saturation as
						  well as hospital capacity and access to care within their respective regions.
E
E
e. Planning and implementation policies and procedures
						  for Mass Casualty Incidents (MCI) developed through collaboration with their
						  respective ReTrAC.
E
E
Educational and Certification Requirements
						  of Designated Trauma Care Personnel
Unless otherwise stated in these regulations, all trauma
						  personnel educational and or certification standards shall be met within six
						  months of employment or contract.
E
E
STATE OF NEW
						  MEXICO
Trauma Care Regulations/Standards for
						  Designation
Pediatric Guidelines for Trauma Center
						  Designation
(E) Essential (D) Desirable (N/A) 3.Not Applicable
Level III
Level IV
(1) HOSPITAL SHALL:
1.1 Meet the requirements of a basic 24-hour emergency
						  facility and be licensed under the New Mexico Administrative Code.
E
E
(2) PROFESSIONAL STAFF: Physician
2.1 All full-time Emergency Department physicians'
						  education should consist of at least 16 hours of pediatric emergency CME credit
						  every 2 years or have an acceptable hospital plan documenting pediatric
						  proficiency.
E
D
(3) PROFESSIONAL STAFF: Nursing
3.1 Emergency Department: At least one Registered Nurse
						  (RN) per shift shall have successfully completed the ENPC or PALS provider
						  course and be designated for providing and/or monitoring pediatric nursing
						  care.
E
D
3.2 Intensive Care Unit (Hospital without PICU): at
						  least one RN per shift shall be currently verified as a PALS provider or
						  equivalent pediatric critical care course and be designated for providing
						  and/or monitoring pediatric nursing care.
E
D
3.3 Post-Anesthesia Care Unit (PACU) or designated
						  post-recovery area: at least one RN per shift shall be currently verified as a
						  PALS provider or have completed competency verification in the post-operative
						  care of the pediatric patient.
E
D
3.4 All nurses assigned to each department for providing
						  and/or monitoring pediatric care shall complete two hours of pediatric
						  education per year.
E
D
3.5 Pediatric Liaison Nurse: one shall be designated.
						  This nurse works in collaboration with the Trauma Nurse Coordinator to ensure
						  and document all pediatric data for the Hospital Trauma Registry and to assist
						  in coordination and documenting pediatric nursing education.
E Note 4
D
3.5.1 Minimum Qualifications include: Works in the ED,
						  ICU, PICU, Pediatric or QI Minimum of one-year experience in the care of the
						  pediatric patient. Completion of at least two hours of education in pediatric
						  topics (in addition to ENPC) per year.
D
D
(4) EQUIPMENT STATNDARDS, EMERGENCY
						  DEPARTMENT
The Emergency Department shall have:
4.1 Resuscitation area with dedicated pediatric
						  equipment.
E Note 1
E Note 1
4.2 Airway control and ventilation equipment
E
E
4.2.1 Laryngoscope blades with handles, curved, straight
						  for infant and child
E
E
4.2.2 Pediatric airways: endotracheal tubes
						  postoperative, cuffed with stylets (all appropriate sizes) and lubricant;
						  pediatric McGill forceps; pediatric airways
E
E
4.2.3 Suction device with pediatric suction catheters
						  (all appropriate sizes)
E
E
4.2.4 Pediatric cricothyroidotomy tray with set up for
						  needle cricothyroidotomy (all appropriate sizes)
E
SC
4.2.5 Pediatric bag-valve-mask (BVM) resuscitation
						  device with premature infant, infant, child and adult clear mask to use with
						  the BVM device with over-riding pop-off valve.
E
D
4.2.6 Oxygen with oxygen-delivery device overriding for
						  premature infant, infant, child and adult clear mask to use.
E
D
4.2.7 Pediatric chest tubes (all appropriate sizes)
E
SC
4.2.8 Pulse oximeter with pediatric and adult sensors
E
D
4.2.9 Equipment for needle thoracostomy for tension
						  pneumothorax
E
D
4.3 Circulatory Support Equipment
4.3.1 Pediatric IV supplies (all appropriate sizes) with
						  IV rate-control devices
E
E
4.3.2 Appropriate fluids for pediatric resuscitation
						  (ACLS/PALS Guidelines)
E
E
4.3.3 Introsseous needles or spinal needles for
						  introsseous infusion (all appropriate sizes)
E
E
4.3.4 Monitor defibrillator and pediatric paddles with
						  0-400 watt/second capabilities
E
E
4.3.5 Pediatric blood-pressure cuffs; premature infant,
						  infants, child, adult and thigh sizes
E
D
4.3.6 Doppler monitor
E
D
4.3.7 Temperature control device for IV fluids
E Note 2
E Note 3
4.3.8 Multilumen catheter (all appropriate sizes)
D
D
4.4 Special Trays
4.4.1 Thoractomy
SC
SC
4.4.2 Thoracostomy
D
SC
4.4.3 Tracheostomy
D
SC
4.4.4 Diagnostic Peritoneal Lavage
D
D
4.4.5 Lumbar Puncture
E
D
4.4.6 Venesection
D
D
4.4.7 Obstetrical Emergency Delivery
E
E
4.5 Miscellaneous Equipment
4.5.1 Spinal Immobilization device: backboards,
						  head-rolls, or head immobilization devices, cervical collars to include sizes
						  for children six years or younger
E
E
4.5.2 Pediatric patient warming devices
E Note 3
E Note 3
4.5.3 Thermometers
E
E
4.5.4 Pediatric Foley catheters (all appropriate sizes)
E
E
4.5.5 Pediatric splinting devices, femur traction
						  device, general traction equipment
E
E
4.5.6 Casting capabilities
E
E
4.5.7 Sterile dressings for burn care
E
E
4.5.8 Nasogastric tubes/infant feeding tubes (all
						  appropriate sizes)
E
E
4.5.9 Pediatric scales for weight measurement
E
E
4.6 Medications; all appropriate medications in
						  pediatric dosages as required for resuscitation (ATLS/PALS recommendations)
E
E
4.7 Pediatric reference materials for drug dosage listed
						  in kg (i.e. Broslow Tape)
E
E
4.8 Quality Management; The hospital shall:
4.8.1 Review all pediatric deaths and transfer
						  complications
E
E
4.8.2 Maintain a pediatric log or registry of all
						  pediatric deaths and transfers
E
E
Notes 1. Pediatric crash carts should be
						  utilized to maintain the proper pediatric equipment and supplies. The pediatric
						  crash cart should be labeled or color coded for clear recognition, 2. Fluid may
						  be warded in standard warmer if IV fluid warming devices are unavailable so
						  long as the appropriate temperature is maintained. 3. Warming methods may be
						  used if devices are unavailable (warmed blankets, warmed bags of IV fluids. 4.
						  The Trauma Nurse Coordinator may meet this standard without the need for
						  additional personnel.
SC Special Consideration: This term is applicable
						  to items that are not essential or desired components for designation. However,
						  facilities wishing to meet specific criteria must provide the appropriate
						  documentation for certifications and ongoing training.