15 Miss. Code. R. 3-2-1.5.1

Current through December 10, 2024

Rule 15-3-2-1.5.1

During the Initial Application for Designation Process and for re-designation STEMI Receiving Centers shall verify the following resources:

a. Hospital Organization

i. STEMI service line or equivalent

ii. STEMI Care Coordinator or Service Line Director

iii. Departments/Sections

* Interventional/Non-Interventional Cardiology

* Cardiac Catheterization Laboratory

* Emergency Department

* Coronary Care Unit

* Cardiovascular Surgery on-site or transfer protocols in place

iv. STEMI Treatment Protocols

* Protocols for triage, diagnosis (ECG < 10 minutes), and Cardiac Catheterization Laboratory activation

* A single activation telephone call should alert the STEMI team

b. Clinical Capabilities

i. Specialty availability (contact made with patient and care plan determined):

* Emergency Medicine - 10 minutes (ECG < 10 minutes)

* Interventional Cardiology - 30 minutes after notification by Emergency Department, or in accordance with hospital STEMI plan

* Cardiac Catheterization Lab - 30 minutes after activation

c. Consultant availability (on-call in accordance with hospital STEMI Plan):

i. Cardiovascular Surgery

ii. Pulmonary/Critical Care

iii. Radiology

iv. Internal Medicine/Hospital Care Services

d. Facilities and Resources

i. Emergency Department

* Personnel

* Designated Physician Director

* Emergency Medicine Specialists

* Nursing personnel with expertise (ACLS/ECG interpretation/cardiac arrhythmia monitoring/cardiac drugs) to monitor patient until admission to a hospital unit or transfer

* Equipment

* Airway control and ventilation equipment Oxygen/Pulse oximetry

* End-tidal CO2 determination

* Suction devices

* 12-lead ECG capability

* Ability to obtain/interpret cardiac bio-markers

* Intravenous fluid administration equipment

* Sterile vascular (venous and arterial) access sets

* Gastric decompression equipment

* ACLS drugs

* Cardiac rhythm monitoring capability

* Bi-phasic cardiac defibrillator equipment

* Emergency temporary pacemaker capabilities (transthoracic/transvenous)

* Intubation/emergency airway management equipment

* Two-way communication capability with EMS ii. Coronary/Intensive Care Unit

* Personnel

* Designated Medical Director

* Critical Care/Pulmonary Medicine/Intensivist (in-house or immediately [ < 30 minutes] available)

* Equipment: Appropriate cardiac monitoring and respiratory support equipment

iii. Cardiac Catheterization Laboratory

* Personnel

* Radiologic staff with experience in cath lab operations and all aspects of diagnostic and interventional PCI

* Nursing staff experienced in cath lab operations,conscious sedation, cardiac monitoring, and cardiac emergencies

* Equipment

* Guiding catheters, a variety of coronary guidewires, a variety of coronary stents

* Advanced hemodynamic and ECG monitoring

* Bi-phasic cardiac defibrillator equipment

* Intravenous anti-thrombin and anti-platelet drugs

* Intravenous vasoactive / vasopressor medications

* Intravenous anti-arrhythmic medications

* Distal protection devices

* Aspiration thrombectomy catheters

* Devices for acute hemodymanic support (i.e., IABP, Impella)

* Temporary transvenous pacemaker

* Intubation/emergency airway management equipment

iv. Rehabilitation

* Protocol for cardiac patients

* Full in-house service or transfer agreement with cardiac rehabilitation facility

v. Laboratory Services

* Standard analyses of blood, urine, etc.

* Blood typing and cross-matching

* Comprehensive blood bank or access to equivalent facility

* Blood gases and pH determinations

* Comprehensive coagulation testing

* Cardiac bio-marker testing

vi. Continuing Education: Formal programs on Acute Coronary Syndrome-STEMI for:

* Staff physicians (Cardiology/Emergency Medicine/Primary Care)

* Nursing (Cardiac Cath Lab/ED/CCU)

* Allied health personnel (Respiratory Therapy/ED technicians)

* Community physicians

* EMS

15 Miss. Code. R. 3-2-1.5.1

Miss. Code Ann. § 41-3-15

Adopted 9/3/2017

Amended 5/25/2018