No. 39468 (Amendment): Rule R426-9. Statewide Trauma System Standards

(Amendment)

DAR File No.: 39468
Filed: 06/29/2015 09:40:32 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this amendment is to update the required trauma center data elements and the addition of other designated patient destinations formerly contained in Rule R426-2. (DAR NOTE: The proposed amendment to Rule R426-2 is under DAR No. 39467 in this issue, July 15, 2015, of the Bulletin.)

Summary of the rule or change:

The updates to trauma center designations reflect new national standards. Other designated patient destinations were updated by the EMS Rules Task Force and approved by the EMS Committee previously found in Rule R426-2.

State statutory or constitutional authorization for this rule:

• Title 26, Chapter 8a

Anticipated cost or savings to:

the state budget:

No anticipated fiscal impact to the state budget because there are no changes in the rule requirements that are imposed by these amendments.

local governments:

Fiscal impacts may include a reduction in long distance ambulance transports and associated patient billing for mileage. Patients in specific situations may now be allowed to travel to closer designated patient receiving facilities as proposed in the amended rule. This may be a positive or negative impact depending on the location of the patient destination.

small businesses:

Possible cost savings to businesses because patient destinations may be changed due to new types of designated patient destinations.

persons other than small businesses, businesses, or local governmental entities:

Possible cost savings to businesses because patient destinations may be changed due to new types of designated patient destinations.

Compliance costs for affected persons:

Patients may potentially save money due to proper initial patient destinations thereby decreasing the need for additional ambulance transfers.

Comments by the department head on the fiscal impact the rule may have on businesses:

There will be some fiscal impact to business in that the proposed changes may decrease the need for long distance ambulance transport.

David Patton, PhD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Family Health and Preparedness, Emergency Medical Services
3760 S HIGHLAND DR
SALT LAKE CITY, UT 84106

Direct questions regarding this rule to:

• Guy Dansie at the above address, by phone at 801-273-6671, by FAX at 801-273-4165, or by Internet E-mail at [e-mail]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

08/14/2015

This rule may become effective on:

08/21/2015

Authorized by:

David Patton, Executive Director

RULE TEXT

R426. Health, Family Health and Preparedness, Emergency Medical Services.

R426-9. [Statewide ]Trauma [System Standards]and EMS System Facility Designations.

R426-9-100. Authority and Purpose for Trauma System Standards.

(1) Authority - This rule is established under Title 26, Chapter 8a, 252, Statewide Trauma System, which authorizes the Department to:

(a) establish and actively supervise a statewide trauma system;

(b) establish, by rule, trauma center designation requirements and model state guidelines for triage, treatment, transport, and transfer of trauma patients to the most appropriate health care facility; and

(c) designate trauma care facilities consistent with the trauma center designation requirements and verification process established by the Department and applicable statutes.

(2) This rule provides standards for the categorization of all hospitals and the voluntary designation of Trauma Centers to assist physicians in selecting the most appropriate physician and facility based upon the nature of the patient's critical care problem and the capabilities of the facility.

(3) It is intended that the categorization process be dynamic and updated periodically to reflect changes in national standards, medical facility capabilities, and treatment processes. Also, as suggested by the Utah Medical Association, the standards are in no way to be construed as mandating the transfer of any patient contrary to the wishes of his attending physician, rather the standards serve as an expression of the type of facilities and care available in the respective hospitals for the use of physicians requesting transfer of patients requiring skills and facilities not available in their own hospitals.

 

R426-9-200. Trauma System Advisory Committee.

(1) The trauma system advisory committee, created pursuant to 26-8a-251, shall:

(a) be a broad and balanced representation of healthcare providers and health care delivery systems; and

(b) conduct meetings in accordance with committee procedures[established by the Department and applicable statutes].

(2) The Department shall appoint committee members to serve terms from one to four years.

(3) The Department may re-appoint committee members for one additional term in the position initially appointed by the Department.

(4) Causes for removal of a committee member include the following:

(a) more than two unexcused absences from meetings within 12 calendar months;

(b) more than three excused absences from meetings within 12 calendar months;

(c) conviction of a felony; or

(d) change in organizational affiliation or employment which may affect the appropriate representation of a position on the committee for which the member was appointed.

 

R426-9-300. Trauma Center Categorization Guidelines.

The Department adopts as criteria for Level I, Level II, Level III, IV and Pediatric trauma center designation, compliance with national standards published in the American College of Surgeons document: Resources for Optimal Care of the Injured Patient [2006]2014.[The Department adopts as criteria for Level IV and Level V trauma center designation the American College of Surgeons document: Resources for Optimal Care of the Injured Patient 1999, except that a Level V trauma center need not have a general surgeon on the medical staff and may be staffed by nurse practitioners or certified physician assistants.]

 

R426-9-400. Trauma Center Review Process.

(1) The Department shall [evaluate]conduct a quality review site visit of trauma centers and applicants to verify compliance with standards set in R426-9-300. In conducting each evaluation, the Department [shall]may consult with experts from the following disciplines:

(a) trauma surgery;

(b) emergency medicine;

(c) emergency or critical care nursing; and

(d) hospital administration.

(2) A consultant shall not assist the Department in evaluating a facility in which the consultant is employed, practices, or has any financial interest.

 

R426-9-500. Trauma Center Categorization Process.

The Department shall:

(1) Develop a survey document based upon the Trauma Center Criteria described in R426-9-300.

(2) Periodically survey all Utah hospitals which provide emergency trauma care to determine the maximum level of trauma care which each is capable of providing.

(3) Disseminate survey results to all Utah hospitals, and as appropriate, to state EMS agencies.

 

R426-9-600. Trauma Center Designation Process.

(1) Hospitals seeking voluntary designation and all designated Trauma Centers desiring to remain designated, shall apply for designation by submitting the following information to the Department at least 30 days prior to the date of the scheduled site visit:

(a) A completed and signed application and appropriate fees for trauma center verification;

(b) a letter from the hospital administrator of continued commitment to comply with current trauma center designation standards as applicable to the applicant's designation level;

(c) the data specified under R426-9-700 are current;

(d) Level I and Level II Trauma Centers must submit a copy of the Pre-review Questionnaire (PRQ) from the American College of Surgeons in lieu of the application in 1a above.

(e) Level III Level IV and Level V trauma centers must submit a complete Department approved application.

(2) Hospitals desiring to be designated as Level I and Level II Trauma Centers must be verified by the American College of Surgeons (ACS) within three (3) months of the expiration date of previous designation and must submit a copy of the full ACS report detailing the results of the ACS site visit. A Department representative must be present during the entire ACS verification or consultation visit. Hospitals desiring to be Level III[,] or Level IV [or Level v ]Trauma Centers must be designated by hosting a formal site visit by the Department.

(3) The Department and its consultants may conduct observation, review and monitoring activities with any designated trauma center to verify compliance with designation requirements.

(4) Trauma centers shall be designated for a period of three years unless the designation is rescinded by the Department for non-compliance to standards set forth in R426-9-600 or adjusted to coincide with the American College of Surgeons verification timetable.

(5) The Department shall disseminate a list of designated trauma centers to all Utah hospitals, and state EMS agencies, and as appropriate, to hospitals in nearby states which refer patients to Utah hospitals.

 

R426-9-700. Data Requirements for an Inclusive Trauma System.

(1) All hospitals shall collect, and monthly submit to the Department, Trauma Registry information necessary to maintain an inclusive trauma system. Designated trauma centers shall provide such data in an electronic format. The Department shall provide funds to hospitals, excluding designated trauma centers, for the data collection process. The inclusion criteria for a trauma patient are as follows:

(a) ICD9 Diagnostic Codes between 800 and 959.9 (trauma); and

(b) At least one of the following patient conditions:[Admitted to the hospital for 24 hours or longer; transferred in or out of your hospital via EMS transport (including air ambulance); death resulting from the traumatic injury (independent of hospital admission or hospital transfer status; all air ambulance transports (including death in transport and patients flown in but not admitted to the hospital).]

(i) Injury resulted in death;

(ii) Admitted to the hospital for 24 hours or longer;

(iii) Patient transferred in or out of reporting hospital via EMS transport; and

(iv) Patient transported via air ambulance, independent of hospital admission or hospital transfer status.

(c) Exclusion criteria are ICD9 Diagnostic Codes:

(i) 930-939.9 (foreign bodies)

(ii) 905-909.9 (late effects of injury)

(iii) 910-924.9 (superficial injuries, including blisters, contusions, abrasions, and insect bites)

(2) The information shall be in a National Trauma Data Standard standardized electronic format [specified by the Department which includes]and include the following NTDS data elements:

([i]a) Demographic Data:

[Tracking Number

Hospital Number

Date of Birth

Age

Age Unit

Sex

Race

Other Race

Ethnicity

Medical Record Number

Social Security Number

Patient Home Zip Code

Patient's Home Country

Patient's Home State

Patient's Home County

Patient's Home City

Patient's Home Zip Code

Alternate Home Residence

(ii) Event Data:

Injury Time

Injury Date

Cause Code

Trauma Type

Work Related

Patient's Occupational Industry

Patient's Occupation

ICD-9/10 Primary E-Code

ICD-9/10 Location E-Code

Protective Devices

Child Specific Restraint

Airbag Deployment

Incident Country

Incident Location Zip Code

Incident State

Incident County

Incident City

Location Code

Injury Details

(iii) Referring Hospital:

Hospital Transfer

Transport Mode into Referring Hospital

Referring Hospital

Referring Hospital Arrival Time

Referring Hospital Arrival Date

Referring Hospital Discharge Time

Referring Hospital Discharge Date

Referring Hospital Admission Type

Referring Hospital Pulse

Referring Hospital Respiratory Rate

Referring Hospital Systolic Blood Pressure

Referring Hospital GCS -Eye

Referring Hospital GCS -Verbal

Referring Hospital GCS -Motor

Referring Hospital GCS Assessment Qualifiers

Referring Hospital GCS Total

Referring Hospital Procedures

(iv) Prehospital:

Transport Mode Into Hospital

Other Transport Mode

EMS Agency

EMS Origin

EMS Notify Time

EMS Notify Date

EMS Respond Time

EMS Respond Date

EMS Unit Arrival on Scene Time

EMS Unit Arrival on Scene Date

EMS Unit Scene Departure Time

EMS Unit Scene Departure Date

EMS Destination Arrival Time

EMS Destination Arrival Date

EMS Destination

EMS Trip Form Received

Initial Field Pulse Rate

Initial Field Respiratory Rate

Initial Field Systolic Blood Pressure

Initial Field Oxygen Saturation

Initial Field GCS-Eye

Initial Field GCS-Verbal

Initial Field GCS-Motor

Initial Field GCS Assessment Qualifiers

Initial Field GCS-Total

(v) Emergency Department/Hospital Information:

Admit Type

Admit Service

ED/Hospital Arrival Time

ED/Hospital Arrival Date

ED Admission Time

ED Admission Date

ED Discharge Time

ED Discharge Date

Inpatient Admission Time

Inpatient Admission Date

Hospital Discharge Time

Hospital Discharge Date

ED Discharge Disposition

ED Transferring EMS Agency

ED Discharge Destination Hospital

Transfer Reason

Hospital Discharge Disposition

Hospital Discharge Destination Hospital

DC Transferring EMS Agency

Outcome

Initial ED/Hospital Pulse Rate

Initial ED/Hospital Respiratory Rate

Initial ED/Hospital Respiratory Assistance

Initial ED/Hospital Systolic Blood Pressure

Initial ED/Hospital Temperature

Initial ED/Hospital Oxygen Saturation

Initial ED/Hospital Supplemental Oxygen

Initial ED/Hospital GCS-Eye

Initial ED/Hospital GCS-Verbal

Initial ED/Hospital GCS-Motor

Initial ED/Hospital GCS Assessment Qualifiers

Initial ED/Hospital GCS-Total

Alcohol Use Indicator

Drug Use Indicator

Inpatient Length of Stay

Total ICU Length of Stay

Total Ventilator Days

Primary Method of Payment

Hospital Complications

Initial ED/Hospital Height

Initial ED/Hospital Weight

Signs of Life

(vi) Hospital Procedures

ICD-9/10 Hospital Procedures

Hospital Procedure Start Time

Hospital Procedure Start Date

(vii) Diagnosis:

Co-Morbid Conditions

Injury Diagnosis Codes

(viii) Injury Severity Information

Abbreviated Injury Scale (AIS) Score

AIS Predot Code

ISS Body Region

AIS Version

Locally Calculated Injury Severity Score

]D_01 Patient's Home Zip Code

D_02 Patient's Home Country

D_03 Patient's Home State

D_04 Patient's Home County

D_05 Patient's Home City

D_06 Alternate Home Residence

D_07 Date of Birth

D_08 Age

D_09 Age Unit

D_10 Race

D_11 Ethnicity

D_12 Sex

(b) Injury Information:

I_01 Injury Incident Date

I_02 Injury Incident Time

I_03 Work-Related

I_04 Patient's Occupational Industry

I_05 Patient's Occupation

I_06 ICD-9 Primary External Cause Code

I_07 ICD-10 Primary External Cause Code

I_08 ICD-9 Place Of Occurrence External Cause Code

I_09 ICD-10 Place Of Occurrence External Cause Code

I_10 ICD-9 Additional External Cause Code

I_11 ICD-10 Additional External Cause Code

I_12 Incident Location Zip Code

I_13 Incident Country

I_14 Incident State

I_15 Incident County

I_16 Incident City

I_17 Protective Devices

I_18 Child Specific Restraint

I_19 Airbag Deployment

I_20 Report Of Physical Abuse

I_21 Investigation Of Physical Abuse

I_22 Caregiver At Discharge

(c) Pre-Hospital Information

P_01 EMS Dispatch Date

P_02 EMS Dispatch Time

P_03 EMS Unit Arrival Date At Scene Or Transferring Facility

P_04 EMS Unit Arrival Time At Scene Or Transferring Facility

P_05 EMS Unit Departure Date From Scene Or Transferring Facility

P_06 EMS Unit Departure Time From Scene Or Transferring Facility

P_07 Transport Mode

P_08 Other Transport Mode

P_09 Initial Field Systolic Blood Pressure

P_10 Initial Field Pulse Rate

P_11 Initial Field Respiratory Rate

P_12 Initial Field Oxygen Saturation

P_13 Initial Field GCS -Eye

P_14 Initial Field GCS -Verbal

P_15 Initial Field GCS -Motor

P_16 Initial Field GCS -Total

P_17 Inter-Facility Transfer

P_18 Trauma Center Criteria

P_19 Vehicular, Pedestrian, Other Risk Injury

(d) Emergency Department Information

ED_01 ED/Hospital Arrival Date

ED_02 ED/Hospital Arrival Time

ED_03 Initial ED/Hospital Systolic Blood Pressure

ED_04 Initial ED/Hospital Pulse Rate

ED_05 Initial ED/Hospital Temperature

ED_06 Initial ED/Hospital Respiratory Rate

ED_07 Initial ED/Hospital Respiratory Assistance

ED_08 Initial ED/Hospital Oxygen Saturation

ED_09 Initial ED/Hospital Supplemental Oxygen

ED_10 Initial ED/Hospital GCS -Eye

ED_11 Initial ED/Hospital GCS -Verbal

ED_12 Initial ED/Hospital GCS -Motor

ED_13 Initial ED/Hospital GCS -Total

ED_14 Initial ED/Hospital GCS Assessment Qualifiers

ED_15 Initial ED/Hospital Height

ED_16 Initial ED/Hospital Weight

ED_17 Alcohol Use Indicator

ED_18 Drug Use Indicator

ED_19 ED Discharge Disposition

ED_20 Signs Of Life

ED_21 ED Discharge Date

ED_22 ED Discharge Time

(e) Hospital Procedure Information

HP_01 ICD-9 Hospital Procedures

HP_02 ICD-10 Hospital Procedures

HP_03 Hospital Procedure Start Date

HP_04 Hospital Procedure Start Time

(f) Diagnosis Information

DG_01 Co-Morbid Conditions

DG_02 ICD-9 Injury Diagnoses

DG_03 ICD-10 Injury Diagnoses

(g) Injury Severity Information

IS_01 AIS Predot Code

IS_02 AIS Severity

IS_03 ISS Body Region

IS_04 AIS Version

IS_05 Locally Calculated ISS

(h) Outcome Information

O_01 Total ICU Length Of Stay

O_02 Total Ventilator Days

O_03 Hospital Discharge Date

O_04 Hospital Discharge Time

O_05 Hospital Discharge Disposition

(i) Financial Information

F_01 Primary Method Of Payment

(x) Quality Assurance Information

Q_01 Hospital Complications

(3) Additional data elements, not included in the NTDS, to be submitted include:

(a) Demographic Information

A.1 Tracking Number

A.2 Hospital Number

A.10 Medical Record Number

A.11 Social Security Number

(b) Injury Information

B.3 Injury Cause Code

B.4 Trauma Type

B.19 Injury Details

(c) Pre-hospital Information

D.3 EMS Agency

D.4 EMS Origin

D.8 EMS Respond Date

D.7 EMS Respond Time

D.14 EMS Destination Arrival Date

D.13 EMS Destination Arrival Time

D.15 EMS Destination

D.16 EMS Trip Form Received

D.24 Initial Field GCS Assessment Qualifiers

(d) Referring Hospital Information

C.1 Hospital Transfer

C.2 Transport Mode into Referring Hospital

C.3 Referring Hospital

C.4 Referring Hospital Arrival Date

C.5 Referring Hospital Arrival Time

C.6 Referring Hospital Discharge Date

C.7 Referring Hospital Discharge Time

C.8 Referring Hospital Admission Type

C.9 Referring Hospital Pulse

C.10 Referring Hospital Respiratory Rate

C.11 Referring Hospital Systolic Blood Pressure

C.12 Referring Hospital GCS -Eye

C.13 Referring Hospital GCS -Verbal

C.14 Referring Hospital GCS -Motor

C.15 Referring Hospital GCS Assessment Qualifiers

C.16 Referring Hospital GCS Total

C.17 Referring Hospital Procedures

(e) Emergency Department Information

E.1 ED Admit Type

E.2 ED Admit Service

E.6 ED Admission Date

E.5 ED Admission Time

E.14 ED Transferring EMS Agency

E.15 ED Discharge Destination Hospital

(f) Inpatient Information

E.10 Inpatient Admission Date

E.9 Inpatient Admission Time

E.12 Hospital Discharge Date

E.11 Hospital Discharge Time

E.16 Transfer Reason

E.18 Hospital Discharge Destination Hospital

E.19 DC Transferring EMS Agency

(vii) Outcome Information

E.20 Outcome

 

R426-9-800. Trauma Triage and Transfer Guidelines.

The Department adopts by reference the 2009 Resources and Guidelines for the Triage and Transfer of Trauma Patients published by the Utah Department of Health as model guidelines for triage, transfer, and transport of trauma patients. The guidelines do not mandate the transfer of any patient contrary to the judgment of the attending physician. They are a resource for pre-hospital and hospital providers to assist in the triage, transfer and transport of trauma patients to designated trauma centers or acute care hospitals which are appropriate to adequately receive trauma patients.

 

R426-9-900. Noncompliance to Trauma Standards.

(1) The Department may warn, reduce, deny, suspend, revoke, or place on probation a facility designation, if the Department finds evidence that the facility has not been or will not be operated in compliance to standards adopted under R426-9-3 00.

(2) A hospital, clinic, health care provider, or health care delivery system may not profess or advertise to be designated as a trauma center if the Department has not designated it as such pursuant to this rule.

 

[R426-9-10. Statutory Penalties.

As required by Section 63G-3-201(5): Any person or agency who violates any provision of this rule, per incident, may be assessed a penalty as provided in Section 26-23-6.

 

]R426-9-1000. Resource Hospital Minimum Designation Requirements.

A Resource Hospital shall meet the following minimum requirements for designation:

(1) Be licensed in Utah or another state as a general acute hospital or be a Veteran's Administration hospital operating in Utah;

(2) Have the ability to communicate with other EMS providers operating in the area;

(3) Provide on-line medical control for all pre-hospital EMS providers who request assistance for patient care, 24 hours-a-day, seven days a week;

(4) Create and abide by written pre-hospital emergency patient care protocols for use in providing on-line medical control for pre-hospital EMS providers;

(5) Train new staff on the protocols before the new staff is permitted to provide on-line medical control and annually review protocols with physician and nursing staff;

(6) Annually provide in-service training on the protocols to all physicians and nurses who provide on-line medical control;

(7) Make the protocols immediately available to staff for reference;

(8) Provide on-line medical control which shall include:

(a) direct voice communication with a physician; or

(b) a registered nurse or physician's assistant, who shall to be licensed in Utah, who is in voice contact with a physician;

(9) Implement a quality improvement process which shall include:

(a) representatives from local EMS providers that routinely transport patients to the resource hospital;

(b) quarterly meetings; and

(c) minutes of the quality improvement meetings which are available for Department review;

(10) Identify a coordinator for the pre-hospital quality improvement process;

(11) Cooperate with the pre-hospital EMS providers' off-line medical directors in the quality review process, including granting access to hospital medical records of patients served by the particular pre-hospital EMS provider;

(12) Participate in local and regional forums for performance improvement; and

(13) Assist the Department in evaluating EMS system effectiveness by submitting to the Department, in an electronic format quarterly data specified by the Department.

 

R426-9-1100. Stroke Treatment and Stroke Receiving Facility Minimum Designation Requirements.

(1) A Primary or Comprehensive Stroke Treatment Center or an Acute Stroke Ready Hospital shall be accredited by the Joint Commission or other nationally recognized accrediting body.

(2) A hospital designated as a Stroke Receiving Facility for receiving stroke patients via Emergency Medical Services shall meet the following requirements:

(a) Be licensed as an acute care hospital in Utah;

(b) Require physician response to the emergency department in less than thirty (30) minutes for treatment of stroke patients;

(c) Maintain the ability of physician and nursing staff to utilize a standardized assessment tool for ischemic stroke patients;

(d) Maintain and utilize approved thrombolytic medications for treatment of patients meeting criteria for administration of thrombolytic therapy;

(e) Establish a standardized acute stroke protocol and authorize appropriate emergency department staff to implement the protocol when appropriate;

(f) Have ancillary equipment and personnel available to diagnose and treat acute stroke patients in a timely manner;

(g) Establish patient transport protocols with designated stroke treatment centers;

(h) Have a performance improvement program for acute stroke care and report data as required by the Department; and

(i) Submit to a site visit by representatives of the Department.

(3) Upon designation, the Department may, in consultation with off line EMS medical direction and protocol, recommend direct transport of stroke patients to a Stroke Receiving Center or a Stroke Treatment Center by an EMS agency.

 

R426-9-1200. Percutaneous Coronary Intervention Center Minimum Designation Requirements.

(1) A Percutaneous Coronary Intervention (PCI) Center, for the purpose of receiving acute ST-elevation myocardial infarction (STEMI) patients via EMS, shall meet the following minimum designation requirements:

(a) Be licensed as an acute care hospital in Utah;

(b) Maintain an emergency department staffed by at least one (1) Physician and one (1) Registered Nurse at all times;

(c) Have the ability to receive 12 lead EKG data from EMS agencies transporting patients to the hospital for treatment of ST Segment Elevation Myocardial Infarction (STEMI);

(d) Maintain the ability to provide cardiac catheterization and PCI of STEMI patients within ninety (90) minutes of patient arrival in the emergency department twenty four (24) hours a day and seven (7) days a week;

(e) Maintain a performance improvement program for STEMI care and report data to the Department as required by the Department; and

(f) Submit to a site visit by representatives of the Department.

(2) Upon designation, the Department may, in consultation with offline EMS medical direction and protocol, recommend direct transport of STEMI patients to a STEMI Treatment Center by an EMS agency.

(3) The PCI designation and re-designation period shall be for a period of three years.

 

R426-9-1300. Patient Receiving Facility Minimum Designation Requirements.

(1) A Patient Receiving Facility shall meet the following minimum designation requirements:

(a) Have the ability to communicate with pre-hospital EMS providers;

(b) Be staffed or have on-call physician, physician assistant, or nurse practitioner availability during designated hours with a response time of less than 20 minutes;

(c) Have and maintain ACLS and PALS certification;

(d) Attend meetings of the local EMS council, if one exists, to participate in the coordination and operations of local EMS providers;

(e) Abide by off-line protocols approved by the EMS provider's off-line medical director;

(f) Train staff on protocols used by the EMS providers who transport patients to the Patient Receiving Facility;

(g) Implement a quality improvement process of all patients received at the patient receiving facility with the local resource hospital or trauma center including access to medical records for patients transported by ambulance;

(h) Maintain equipment, services and medications on-site to provide Advanced Life Support (ALS) intervention and appropriate treatment. Equipment and services shall include:

(i) ECG;

(ii) ACLS medications;

(iii) laboratory services;

(iv) radiology services;

(v) oxygen delivery systems;

(vi) airway support equipment and supplies;

(vii) suction equipment and supplies; and,

(i) Submit to a yearly site visit by representatives of the Department; and

(j) Submit monthly data reports to the Department on all patients received by an ambulance, and in an electronic format provided by the Department.

(2) The Department may recommend the preferential transportation of STEMI patients by ambulance to a Patient Receiving Facility.

 

KEY: emergency medical services, trauma, reporting, trauma center designation

Date of Enactment or Last Substantive Amendment: [October 18, 2013]2015

Authorizing, and Implemented or Interpreted Law: 26-8a-252

 

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