Md. Code Regs. 30.09.11.04

Current through Register Vol. 51, No. 22, November 1, 2024

Section 30.09.11.04 - Additional Requirements for Obstetrical Transports

A. An ALS-licensed ambulance may not transport an obstetrical patient from one hospital to another for a higher level of obstetrical care unless:

(1) The admitting hospital:

(a) Is a perinatal center;

(b) Before designation of perinatal centers by the EMS Board, has a certificate of need issued by the Maryland Health Resources Planning Commission for its neonatal intensive care unit or approval from the Health Services Cost Review Commission for a neonatal intensive care cost center; or

(c) Before the EMS Board has completed the process of entering into an agreement with an out-of-State hospital to serve as an out-of-State perinatal referral center, possesses all government approvals required to operate a neonatal intensive care unit under the laws of the jurisdiction in which it is located including, if required, a certificate of need and all necessary licenses;

(2) The additional equipment required under §B of this regulation is onboard; and

(3) In addition to the staffing required under COMAR 30.09.07.02A(4), there is a registered nurse or physician experienced in the care of obstetrical patients onboard.

B. Equipment Requirements.

(1) The additional equipment required under §B(2) of this regulation may be provided by the referring or admitting hospital and shall be onboard when transporting an obstetrical patient.

(2) In addition to the equipment required under COMAR 30.09.10 and this chapter, the following shall be onboard:

(a) One doppler;

(b) One reflex hammer;

(c) One neonatal bag valve mask with manometer and newborn and premature infant size masks;

(d) One IV infusion pump; and

(e) The following medications:

(i) Four vials oxytocin (10 units/milliliter);

(ii) Two vials methergine (0.2 milligram/milliliter);

(iii) Two vials 10 percent calcium gluconate (10 milliliters);

(iv) Three vials terbutaline (1 milligram/milliliter); and

(v) Eight vials 50 percent magnesium sulfate (10 milliliters).

C. Additional Record Keeping Requirements.

(1) In addition to the requirements in COMAR 30.09.08, the following information shall be documented on the patient report:

(a) Name of the referring hospital;

(b) Name of the referring physician;

(c) Name of the receiving hospital;

(d) Name of the receiving physician;

(e) Names and license or certification level of the commercial ambulance driver and commercial ambulance personnel;

(f) Time the request for transport was received by the commercial ambulance service;

(g) Time en route to the referring hospital;

(h) Time of arrival at the referring hospital;

(i) Time of departure from the referring hospital;

(j) Time of arrival at the admitting hospital;

(k) Maternal gestational age;

(l) Reason for transport; and

(m) Care provided during transport.

(2) Patient care reports and EMS data shall be submitted in accordance with COMAR 30.03.04.04A.

D. The additional requirements for obstetrical transports listed in §§A and B of this regulation may be waived when an ALS-licensed commercial ambulance is transporting an uncomplicated obstetrical patient from a hospital without an obstetrical service.

Md. Code Regs. 30.09.11.04

Regulations .04 adopted as an emergency provision effective January 6, 1997 (24:2 Md. R. 114); adopted permanently effective July 7, 1997 (24:10 Md. R. 711)
Regulations .04, Specialized Service, repealed and new Regulations .01_.05, ALS Service, adopted effective January 10, 2000 (26:27 Md. R. 2017)
Regulation .04C amended effective November 1, 2010 (37:21 Md. R. 1437)