STEMI Critical Care System Requirements.

22 CCR 100146.01

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22 CCR 100146.01

§ 100146.01. STEMI Critical Care System Requirements.

(a)

A local EMS agency (LEMSA) may develop and implement a STEMI critical care system.

(b)

Plan Requirement. A LEMSA that is implementing a new STEMI critical care system program must develop a STEMI critical care system plan in accordance with Section 100146.03 of this article and submit the plan to the Emergency Medical Services Authority (EMSA) for approval prior to implementation. For an EMSA-approved STEMI critical care system, the LEMSA shall annually submit a STEMI critical care plan update in accordance with Section 100146.04 of this article. Each STEMI critical care system plan and update shall, at a minimum, comply with the provisions of Division 2.5 of the Health and Safety Code and the requirements set forth in this chapter. A LEMSA may establish additional requirements in addition to those mandated by statute and state minimum standards.

(c)

Planning Responsibilities. For the development, implementation, and ongoing evaluation of its STEMI critical care system plan under this subchapter, the LEMSA is responsible for, at a minimum:

(1)

Cardiac Care Committee. Establishing a cardiac care committee, as set forth in Section 100146.02 of this article.

(2)

Program Objectives. Determine STEMI critical care system goals and objectives.

(3)

Designation and Oversight. Designate and review STEMI receiving centers and STEMI referring hospitals in accordance with Articles 4 and 5 of this subchapter.

(4)

Policies. Developing and implementing policies, procedures, and protocols for the treatment and transport of STEMI patients. This shall include, at a minimum:

(A)

Prehospital STEMI and Cardiac Care Requirements. Policies and protocols for the identification, treatment, and appropriate destination of STEMI patient or other critical cardiac patients. These policies and protocols shall include:

(i)

Prehospital ECG Interpretation. The findings of 12-lead electrocardiograms (ECGs) performed in the field shall be assessed and interpreted through one or more of the following methods:

(I)

Direct paramedic interpretation;

(II)

Automated computer algorithm;

(III)

Wireless transmission to a receiving facility followed by physician interpretation or confirmation.

(ii)

Advance Notification to STEMI Center. Notification of prehospital ECG findings of suspected STEMI patients, as defined by the LEMSA, shall be communicated by EMS personnel in advance of arrival to the STEMI center.

(i)

ECG Data Submission. 12-lead ECGs performed in the field shall be uploaded with the electronic patient care record (ePCR) to the LEMSA. For LEMSAs that do not maintain a separate ePCR database, the ECGs shall be uploaded to CEMSIS.

(B)

Interfacility Transfer. A policy facilitating the interfacility transfer of acute STEMI patients;

(C)

Regional Integration. A policy integrating a receiving center or receiving centers located in a neighboring jurisdiction.

(5)

System Coordination Agreements. Developing and implementing agreements necessary for the coordinated treatment and transport of STEMI patients within the STEMI critical care system and region, including:

(A)

Coordination with neighboring local EMS systems;

(B)

Designated STEMI receiving center agreements;

(C)

Inter-LEMSA agreements.

(6)

Public Education and Outreach. A description of programs that conduct or promote public education specific to cardiac care.

(7)

Data Collection, Quality Improvement, and Evaluation. Collecting and reporting STEMI patient care data, establishing and maintaining a QI process, and performing STEMI critical care system evaluation in accordance with Article 5 of this subchapter.

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