Md. Code Regs. 30.08.05.07
PARC | I | II | III | ED | |
A. General Surgery. A hospital shall have a surgery department including: | |||||
(1) For the "most critical patients" an in-house, fellowship trained attending trauma surgeon, trauma fellow or trauma fellow equivalent/PGY5+ general surgery resident should be at the bedside upon arrival, documented at least 80 percent of the time. | E | NA | NA | NA | NA |
(2) Either: | |||||
(a) A trauma or general surgeon trained in trauma care who shall be at the bedside within 15 minutes of being called for the highest level of activation and should be at the bedside within 15 minutes with compliance demonstrated at least 80 percent of the time; | NA | E | E | NA | NA |
(b) An in-house PGY4 or more senior resident who shall be at the bedside with the attending trauma or general surgeon within 15 minutes of being called for the highest level of activation and should be at the bedside within 15 minutes with compliance demonstrated at least 80 percent of the time; or | NA | E | E | NA | NA |
(c) An in-house APP trained in trauma care who shall be at the bedside with the attending trauma or general surgeon within 15 minutes of being called for the highest level of activation and should be at the bedside within 15 minutes with compliance demonstrated at least 80 percent of the time; | NA | E | E | D | NA |
(3) An attending trauma surgeon taking trauma call who shall be at the bedside within 30 minutes from patient arrival for the highest level of activation with the surgeons' presence with compliance demonstrated at least 80 percent of the time; | NA | NA | NA | E | NA |
(4) Trauma or general surgeons who are board certified or board eligible, | E | E | E | E | NA |
(5) Trauma or general surgeons who agree to actively participate in a defined continuing education program; | E | E | E | E | D |
(6) Criteria and protocols for the notification and response of a trauma or general surgeon; | E | E | E | E | NA |
(7) General Surgery APPs taking trauma call who have evidence of average of 16 hours a year or 32 hours in 2 years of trauma-related education; and | E | E | E | E | NA |
(8) A liaison to the trauma QM program with 50 percent attendance. | E | E | E | E | NA |
B. Neurosurgery. Neurosurgery requirements are as follows: | |||||
(1) Neurosurgeons who are board certified or board eligible; | E | E | E | E | E |
(2) A Board-certified or board-eligible, trauma fellowship-trained in-house neurosurgery attending or PGY2 or higher, dedicated 24 hours a day to trauma care with a Neurosurgery Attending on-call and who shall be at the patient bedside within 30 minutes after Emergent consultation has been requested by the trauma team leader for injured patients based on institution-specific criteria; | E | E | NA | NA | NA |
(3) The on-call Neurosurgery Attending taking trauma call shall be at the bedside within 30 minutes after Emergent consultation has been requested by the trauma team leader for injured patients based on institution-specific criteria and with in-house physician capable of initiating stabilization and diagnostic procedures; | NA | NA | E | E | NA |
(4) If a neurosurgeon taking trauma call covers more than one hospital within the same geographic area, there shall be a written contingency plan in place for times in which a neurosurgeon is unavailable upon the arrival of a Neurotrauma case; | NA | NA | E | E | E |
(5) A qualified Neurosurgeon shall be regularly involved in the care of patients with neurologic injuries and shall be credentialed by the hospital with general neurosurgical privileges; | E | E | E | E | E |
(6) Neurosurgery APP or PGY2 or higher with attending on-call; | NA | NA | E | E | E |
(7) Neurosurgery APPs taking trauma call shall have evidence of average of 16 hours a year or 32 hours in 2 years of trauma-related education; and | E | E | E | E | NA |
(8) A liaison to the trauma QM program with 50 percent attendance. | E | E | E | E | NA |
D. Orthopedic Surgery. Orthopedic surgery requirements are as follows: | |||||
(1) A Board-certified or board-eligible, trauma fellowship-trained in-house orthopedic attending or PGY2 or higher, dedicated 24 hours a day to trauma care with an Orthopedic Attending on-call and who shall be at the patient bedside within 30 minutes after Emergent consultation has been requested by the trauma team leader for injured patients based on institution-specific criteria; | E | E | NA | NA | NA |
(2) Orthopedic team members shall have dedicated call at their institution or have an effective backup call system. If the on-call orthopedic surgeon is unable to respond promptly, a backup consultant on-call surgeon shall be available; | E | E | E | E | E |
(3) Board-certified or board-eligible on-call attending with a 30-minute response after emergent response is requested; | NA | NA | E | E | NA |
(4) Orthopedic APPs taking trauma call who have evidence of average of 16 hours a year or 32 hours in 2 years of trauma-related education; and | E | E | E | E | NA |
(5) A liaison to the trauma QM program with 50 percent attendance. | E | E | E | E | NA |
Md. Code Regs. 30.08.05.07