Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0056 - Trauma Program, Wyoming › Chapter 4 - FACILITY STANDARDS › Section 4-2 - Area Trauma Hospitals

Current through July 13, 2024
An Area Trauma Hospital (ATH) is an acute care facility with
				  the commitment, medical staff, personnel, and specialty training necessary to
				  provide primary care to the trauma patient. An ATH shall provide initial
				  resuscitation of the trauma patient and immediate operative intervention to
				  control hemorrhage and to assure maximal stabilization prior to referral to a
				  higher level of care. In many instances, patients will be maintained in the ATH
				  unless the medical needs of the patient require a higher level of care. The
				  decisions to transfer a patient rests with the physician attending the trauma
				  patient. All ATHs shall work collaboratively with the Regional Trauma Centers,
				  Community Trauma Hospitals and Trauma Receiving Facilities to develop transfer
				  protocols and a well-defined transfer sequence.
(a) Hospital Organization.
(i) Trauma Program. The trauma program shall
				be established and recognized by the medical staff and hospital administration.
				The trauma program shall come under the overall organization and direction of a
				general surgeon or emergency physician who is trained, experienced, and
				committed to the care of the injured patient.
(ii) Trauma Program Director. The director
				must be a board certified surgeon or a board certified emergency physician with
				demonstrated competency in trauma care. The director shall develop a quality
				improvement process and through this process, shall be responsible for all
				trauma patients and administrative authority for the hospital's trauma program.
				The director must be given administrative support to implement the requirements
				specified by the Wyoming Trauma Plan. The director shall work with the
				credentialing process of the hospital and participate with the credentialing
				committee to recommend participation on the trauma
				team.12
(iii) Trauma Team. The hospital shall have a
				policy describing the respective roles of all personnel on the trauma team. The
				composition of the trauma team in any hospital will depend on the
				characteristics of that hospital and its staff. The team leader shall be a
				qualified physician who is clinically capable in all aspects of trauma
				resuscitation. Suggested composition of the trauma team may include:
(A) Surgeons, General, and Orthopedic;
(B) Anesthesiologists;
(C) Emergency physicians;
(D) Family physicians;
(E) Laboratory technicians;
(F) Registered nurses;
(G) Physician specialists as dictated by
				clinical needs;
(H) Prehospital
				care providers;
(I) Radiology
				technicians;
(J) Respiratory
				therapists; and
(K) Social
				services/pastoral care.
(iv) Qualifications for Surgeons on the
				Trauma Team. As a general rule, all surgeons on the trauma team should be board
				certified in a surgical specialty recognized by the American Board of Medical
				Specialties, the Canadian Board or the American Osteopathic Association. An
				exception to this rule is Oral and Maxillofacial Surgery. These physicians
				should be board certified by the American Board of Oral and Maxillofacial
				Surgery.13 The surgeons shall participate in the
				multi disciplinary trauma committee and the quality improvement process. All
				general surgeons participating on the trauma team should be current in ATLS and
				be involved in continuing education specific to trauma sufficient to maintain
				quality patient care. This includes all residents.
(v) Trauma Nurse Coordinator. An ATH shall
				have a registered nurse working in the role of a trauma nurse coordinator.
				Working in conjunction with the trauma program director, the trauma nurse
				coordinator shall organize the program and all systems necessary for the multi
				disciplinary approach throughout the continuum of trauma care. The trauma nurse
				coordinator is responsible for coordinating optimal patient care for all
				injured patients.14
(vi) Multi Disciplinary Trauma Committee. The
				purpose of the committee is to provide oversight and leadership to the entire
				trauma program. The major focus shall be quality improvement activities, policy
				development, communication among all team members, development of standards of
				care, education and outreach programs and work with appropriate groups for
				injury prevention. The clinical managers (or designees) of the organizational
				areas involved with trauma care shall play an active role with the committee.
				The committee shall include representatives from each of the following areas,
				unless the hospital has no such organizational area defined:
(A) Administration;
(B) Anesthesia;
(C) Emergency Department;
(D) General Surgery;
(E) Intensive Care;
(F) Laboratory;
(G) Medical Records;
(H) Nursing;
(I) Operating Room;
(J) Orthopedics;
(K) Pediatrics;
(L) Prehospital care providers;
(M) Radiology;
(N) Rehabilitation;
(O) Respiratory Therapy; and
(P) Trauma Nurse Coordinator.