6 Colo. Code Regs. § 1011-1 Chapter 13, pt. 18

Current through Register Vol. 47, No. 20, October 25, 2024

Part 18 - EMERGENCY SERVICES

18.1 Organization

(A) The FSED shall develop and implement policies and procedures outlining the scope of services provided.

(B) Each patient shall be discharged only upon a provider's recorded authorization including instructions given to the patient for follow-up care, modified diet, medications, and signs and symptoms to be reported to a provider, if relevant, and a contact to call in case the patient has questions after discharge.

(C) The location and telephone number of a poison control center shall be posted prominently in the FSED.

18.2 Emergency Services Personnel

(A) An appropriately educated and qualified emergency physician shall be on-site at all times.

(B) At a minimum, there shall be at least one registered nurse on-site at all times. There shall be sufficient registered nurses with adequate training and experience to meet the needs of patient census.

(C) There shall be procedures for accessing additional staff to meet unanticipated needs.

18.3 Services

(A) Emergency services shall be provided 24 hours per day, 7 days per week, including providing evaluation and stabilization of both adult and pediatric patients who present for care.

(B) At a minimum, the FSED shall provide the necessary resources to address emergencies for both adult and pediatric patients, including, but not limited to: airway, cardiac, circulatory, neurologic, obstetric, orthopedic, pulmonary, and behavioral health.

(C) The FSED shall provide, at a minimum, the following services on-site:

(1) Initial stabilization and treatment for any acute medical, traumatic, and/or behavioral health patient.

(2) Radiology, imaging, and other diagnostic services to include x-ray, CT scan, and ultrasound services.

(3) Laboratory services, to include those services necessary to evaluate and treat patients within the facility's scope of services.

(4) Pharmacy services, to include the drugs necessary for the services provided within the facility's scope of care.

(5) Procedural sedation or regional anesthesia used during the course of providing treatment.

(D) All patients presenting for emergency services shall be offered a medical screening exam and stabilizing treatment within the capability of the FSED for emergency medical conditions identified by a medical screening exam, regardless of an individual's ability to pay, method of payment, or insurance status.

18.4 The FSED shall develop and implement policies, procedures, and/or guidelines for the following:

(A) Clinical care that shall be based on nationally-recognized guidelines, procedure manuals, and reference materials.

(B) An easily accessible centralized log of each individual presenting who is in need of emergency services and whether the individual refused treatment, left without being seen, eloped, was transferred, was admitted, died, or was discharged.

(C) Processing patients presenting for emergency services including procedures for initial assessment, prioritization for medical screening and treatment, and patient reassessment and monitoring.

(D) Provision of further medical examination and such treatment as may be required to stabilize or transfer the individual within the staff and FSED's capabilities.

(E) Transfer of patients to a higher level of care when their needs exceed the FSED's capabilities. The transferring FSED must send all pertinent medical records available at the time of transfer, effect the transfer through qualified persons and transportation equipment, and obtain the consent of the receiving facility.

18.5 Equipment

The FSED shall have the instruments, equipment, and other resources to deliver services to adult and pediatric patients commensurate with the required services described in Part 18.3. The FSED may look to national guidelines and evidence-based medical practice to inform decision-making on necessary resources.

6 CCR 1011-1 Chapter 13, pt. 18