Stroke Critical Care System Requirements.

22 CCR 100151.01

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22 CCR 100151.01

§ 100151.01. Stroke Critical Care System Requirements.

(a)

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

(b)

Plan Requirement. A LEMSA that is implementing a new stroke critical care system program must develop a stroke critical care system plan in accordance with Section 100151.03 of this article and submit the plan to the Emergency Medical Services Authority (EMSA) for approval prior to implementation. For an EMSA-approved stroke critical care system, the LEMSA shall annually submit a stroke critical care plan update in accordance with Section 100151.04 of this article. Each stroke 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 stroke critical care system plan under this subchapter, the LEMSA is responsible for, at a minimum:

(1)

Stroke Critical Care System Advisory Committee. Establishing a stroke critical care system advisory committee, as set forth in Section 100151.02 of this article.

(2)

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

(3)

Designation and Oversight. Designate and review stroke centers 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 stroke patients. This shall include, at a minimum:

(A)

Prehospital stroke care requirements. Policies and protocols for the early recognition, treatment, and appropriate destination of stroke patients. These policies and protocols shall include:

(i)

Prehospital Stroke Screening. The use of a prehospital strokescreening algorithm validated in the medical literature for early recognition and assessment, to include the LEMSA's definition of suspected stroke patient.

(ii)

Use of Online or Direct Medical Control. Consider the use of online/direct medical control to determine the most appropriate stroke center for transport when a patient presents with confusing or complex findings suggestive of stroke.

(iii)

Advance Notification to Stroke Center. Notification of prehospital findings of suspected stroke patients shall be communicated by EMS personnel in advance of arrival to the stroke center.

(B)

Interfacility transfer. A policy to facilitate the interfacility transfer of acute stroke patients.

(C)

Regional Integration. A policy for the integration of stroke centers located in neighboring jurisdictions.

(5)

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

(A)

Coordination with neighboring local EMS systems;

(B)

Designated stroke center agreements;

(C)

Inter-LEMSA agreements.

(6)

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

(7)

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

(d)

Mobile Stroke Unit. The LEMSA may develop a Mobile Stroke Unit (MSU) component within the stroke critical care system. A LEMSA incorporating an MSU shall be responsible for developing and implementing MSU policies and procedures as well as a QI plan for MSU operations.

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