D.C. Mun. Regs. tit. 22, r. 22-B2705
Each adult trauma care facility shall have the following specialties available in-house twenty-four (24) hours per day:
The patient evaluation and treatment team shall consist of a team of surgeons that will include, at a minimum, a post-graduate resident in at least the fourth (4th) year of training.
The attending surgeon shall participate in each major therapeutic decision and be present at each operative procedure. The hospital's trauma performance improvement program shall monitor compliance with the requirements of this section.
An attending neurosurgeon shall be available and dedicated to that hospital's trauma service. This requirement may be satisfied by an in-house neurosurgery resident or physician who has special competence, as judged by the chief of neurosurgery, in the care of patients with neurological trauma, and who is capable of initiating measures directed toward stabilizing the patient and initiating diagnostic procedures.
The requirement to provide emergency medical services may be fulfilled by an emergency medicine chief resident capable of assessing emergency situations in trauma patients and providing any indicated treatment. When senior residents are used to fulfill availability requirements, the staff specialist on-call shall be advised and be available for consultations.
In Level I facilities, the requirement to provide anesthesiology services may be satisfied by anesthesiology chief residents or a certified nurse anesthetist (CRNA) capable of assessing emergency situations in trauma patients and providing any indicated treatment, including surgical anesthesia. Whenever a Level I facility uses an anesthesiology resident or a certified nurse anesthetist (CRNA) to satisfy this requirement, the facility shall notify the staff anesthesiologist on-call, who shall be promptly available.
In Level II facilities, the requirement to provide anesthesiology services is satisfied when the staff anesthesiologist is in the hospital at the time of, or shortly after, the patient's arrival. Before the staff anesthesiologist arrives, an anesthesiology chief resident or certified nurse anesthetist (CRNA) capable of assessing emergency situations in trauma patients and of initiating and providing any indicated treatment shall be available.
Each Level I facility shall have personnel on-call and promptly available with competence to assess and/or perform procedures in the following areas:
Each Level II facility shall have personnel on-call and available with the competence to perform procedures in the following areas:
Each Level II facility may have personnel on-call and available with competence to perform procedures in the following areas:
In non-surgical specialty cases, the patient's primary care physician shall be notified at an appropriate time.
Thoracic surgery may be performed by a general trauma surgeon with privileges to provide thoracic surgical care to patients with thoracic injuries.
Transplant specialists shall be provided as follows:
D.C. Mun. Regs. tit. 22, r. 22-B2705