Mo. Code Regs. tit. 19 § 30-40.780

Current through Register Vol. 49, No. 18, September 16, 2024

Section 19 CSR 30-40.780 - Definitions and Abbreviations Relating to the Transport Protocol for Stroke and the Transport Protocol for ST-Segment Elevation Myocardial Infarction (STEMI) Patients

PURPOSE: This rule defines terminology related to the state transport protocol for stroke and the state transport protocol for STEMI.

(1) The following definitions and abbreviations shall be used in the interpretation of the rule in 19 CSR 30-40.790:

(A) Field is the specific area or location, outside of the hospital, where an injury, accident, or medical emergency occurs requiring immediate assistance of medical personnel for the purpose of treating or transporting the sick or injured to another location for treatment;

(B) Local and regional process is the process that has been established and agreed upon specifically pertaining to a local city, town, or small district, or a combination of localities forming a regional area. This is not the community-based or regional plan;

(C) Lytics are thrombolytic drugs, including recombinant tissue plasminogen activator, used to dissolve clots blocking flow in a blood vessel. These lytic/thrombolytic drugs are used in the treatment of acute ischemic stroke and acute myocardial infarction;

(D) Lytic/therapeutic window is the period of time during which lytics can be administered following the onset of symptoms in order to reduce brain or heart injury;

(E) Lytic therapy (fibrinolysis/thromboly-sis) is drug therapy used to dissolve clots blocking flow in a blood vessel. It refers to drugs used for that purpose, including recombinant tissue plasminogen activator. This type of therapy can be used in the treatment of acute ischemic stroke and acute myocardial infarction;

(F) Lytic/thrombolytic ineligible patients are those patients identified as ineligible for lytic/thrombolytic therapy due to specific contraindications. An appropriate course of treatment will be utilized when lytic/thrombolytic therapy is contraindicated;

(G) Out of the lytic/therapeutic or potential therapeutic window is the period of time following the accepted time (lytic/therapeutic window and potential therapeutic window) frames for specific therapies for a patient suffering an ischemic stroke;

(H) Outside of the percutaneous coronary intervention (PCI) window is the period of time following the accepted time frame in which PCI is most advantageous and recommended;

(I) Percutaneous coronary intervention (PCI) is a procedure used to open or widen narrowed or blocked blood vessels to restore blood flow supplying the heart;

(J) Percutaneous coronary intervention (PCI) window is a time frame in which PCI is most advantageous and recommended;

(K) Potential therapeutic window is the period of time after the accepted window for lytic therapy has expired in which interventional therapy may be beneficial in restoring blood flow during an ischemic stroke; and

(L) Recombinant tissue plasminogen activator (t-PA also known as rt-PA) is a thrombolytic (clot-dissolving) agent, the goal of which is to destroy the thrombus (clot) within the blood vessel by stimulating fibrinolysis (clot breakdown) to allow restoration of blood flow.

19 CSR 30-40.780

AUTHORITY: sections 190.185 and 190.241, RSMo Supp. 2012.* Original rule filed Nov. 15, 2012, effective June 30, 2013.

*Original authority: 190.185, RSMo 1973, amended 1989, 1993, 1995, 1998, 2002 and 190.241, RSMo 1987, amended 1998, 2008.