Rule 15-12-32-6.1.9 - Required Clinical Components1. Tertiary pediatric trauma centers must maintain published call schedules and have the following physician coverage immediately available 24 hours/day:2. Pediatric 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. The ED liaison on the trauma team must be board certified, maintain 48 hours of trauma related CME over a three year period, and must maintain current ATLS certification. The liaison must attend a minimum of 50% of peer review committee meetings annually and must participate in the Multidisciplinary Trauma Committee.3. Trauma/General/Pediatric Surgery (in-house 24 hours/day). The surgeon covering pediatric trauma call must be unencumbered and immediately available to respond to the pediatric 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. The surgeon is expected to be in the ED upon arrival of the seriously injured pediatric patient. The surgeon's participation in major therapeutic decisions, presence in the ED 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 at any other hospital while on trauma call. A system must be developed to assure early notification of the on-call surgeon and compliance with these criteria and their appropriateness must be documented and monitored by the PI process. The surgery liaison on the trauma team must be board certified, maintain 48 hours of trauma related CME over a three year period, and must maintain current ATLS certification. The liaison must attend a minimum of 50% of peer review committee meetings annually and must participate in the Multidisciplinary Trauma Committee. 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 from patient arrival.4. Orthopedic Surgery. The pediatric orthopedic liaison on the pediatric trauma team must be board certified, maintain 48 hours of trauma related CME over 3 years, and it is desirable to maintain current ATLS certification. The orthopedic liaison to the pediatric trauma team must attend a minimum of 50% of the peer review committees annually and participate in the Multidisciplinary Trauma Committee. It is desirable to have the orthopedic surgeon dedicated to the pediatric trauma center solely while on-call, but if not dedicated, a published back-up call schedule must be available. Response time for all trauma activations is 60 minutes from the time notified to respond.5. Neurological Surgery. The neurosurgeons on the pediatric trauma team must be board certified. The pediatric neurosurgery liaison must maintain 48 hours of trauma related CME over 3 years, and it is desirable to maintain current ATLS certification. The pediatric neurosurgeon liaison to the pediatric trauma team must attend a minimum of 50% of the peer review committees annually and participate in the Multidisciplinary Trauma Committee. It is desirable to have the neurosurgeon dedicated to the pediatric trauma center solely while on-call, but if not dedicated, a published back-up call schedule must be available. Response time for all trauma activations is 30 minutes from the time notified to respond.6. Anesthesia (in-house 24 hours/day). Anesthesia must be 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 nurse anesthetist (CRNA) 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.7. The following specialists must be committed to pediatric trauma care, on-call and promptly available 24 hours/day:c. Critical Care Medicinei. Obstetrics/Gynecologic Surgerym. Pediatric Critical Care Medicinen. Pediatric Rehabilitations. Child Life or Family Support Programs * The trauma surgeon is presumed to be qualified and have privileges to provide emergency thoracic surgical care to pediatric patients with thoracic injuries. If this is not the case, the facility should have a board-certified thoracic surgeon immediately available for the injured pediatric patient (within 30 minutes of the time notified to respond).
8. Recognizing that early rehabilitation is imperative for the pediatric trauma patient, a physical medicine and pediatric rehabilitation specialist must be available for the pediatric trauma team.9. Policies and procedures should exist to notify the transferring hospital of the patient's condition.15 Miss. Code. R. 12-32-6.1.9
Miss. Code Ann. § 41-59-5