Rule 15-12-32-2.2.1 - Required ComponentsLevel I trauma centers must maintain published call schedules and have the following physician coverage immediately available 24 hours/day:
1. 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.2. Trauma/General Surgery (In-house 24/hours). The trauma surgeon on-call must be unencumbered and immediately available to respond to the 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. This may allow the attending surgeon to take call from outside the hospital. The general surgeon is expected to be in the emergency department upon arrival of the seriously injured patient. Hospital policy must be established to define conditions requiring the trauma surgeon's presence with the clear requirement on the part of the hospital and surgeon that the surgeon will participate in the early care of the patient. The trauma surgeon's participation in major therapeutic decisions, presence in the emergency department 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 to any other hospital while on trauma call. A system must be developed to assure early notification of the on-call to any other hospital while on trauma call. A system must be developed to assure notification of the on-call surgeon and compliance with these criteria and their appropriateness must be documented and monitored by the PI process. 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 and starts at patient arrival or EMS notification, whichever is shorter.3. Orthopedic Surgery. It is desirable to have the orthopedists dedicated to the trauma center solely while on-call or a back up schedule should be available. The maximum response time for all trauma patients is 60 minutes from the time notified to respond.4. Neurologic Surgery. It is desirable to have the neurosurgeon dedicated to the trauma center solely while on-call or a back up schedule should be available. The maximum response time for all trauma patients is 30 minutes from the time notified to respond.5. Anesthesia (In-house 24 hours/day) Anesthesia must be immediately 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 Registered Nurse Anesthetist (CRNAs) 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.6. The following specialists must be on-call and promptly available 24 hours/day: c. Critical Care Medicinei. Obstetrics/Gynecologic Surgeryp. Thoracic Surgery* *A trauma surgeon is presumed to be qualified and have privileges to provide emergency thoracic surgical care to patients with thoracic injuries. If this is not the case, the facility should have a board-certified cardiac/thoracic surgeon immediately available (within 30 minutes of the time notified to respond).
7. Recognizing that early rehabilitation is imperative for the trauma patient, a physical medicine and rehabilitation specialist must be available for the trauma program8. Policies and procedures should exist to notify the transferring hospital of the patient's condition.15 Miss. Code. R. 12-32-2.2.1
Miss. Code Ann. § 41-59-5