WAC 246-976-620   Equipment standards for trauma service designation.  


LEVELS
A facility with a designated trauma service must: I IP II IIP III IIIP IV V
(1) Have the following equipment, both adult and pediatric sizes in the emergency department (or resuscitation area for level V):                
(a) Airway control and ventilation equipment, including:                
(i) Airways; X X X X X X X X
(ii) Laryngoscopes, including curved and straight blades; X X X X X X X X
(iii) Endotracheal tubes, with stylets available; X X X X X X X X
(iv) Bag-valve-mask resuscitator; X X X X X X X X
(v) Pulse oximeter; X X X X X X X X
(vi) CO2 measurement; X X X X X X X X
(vii) Sources of oxygen; X X X X X X X X
(viii) Ability to provide mechanical ventilation; X X X X X X    
(b) Suction devices, including: X X X X X X    
(i) Back-up suction source; X X X X X X X X
(ii) Suction catheters; X X X X X X X X
(iii) Tonsil tip suction (except level V clinics); X X X X X X X X
(c) Cardiac devices, including:                
(i) Cardiac monitor; X X X X X X X X
(ii) Defibrillator; X X X X X X X X
(iii) Electrocardiograph; X X X X X X X X
(iv) Portable cardiac monitor; X X X X X X X X
(v) Blood pressure cuffs; X X X X X X X X
(vi) Doppler device; X X X X X X X  
(d) Intravenous supplies, including:                
(i) Standard intravenous fluids and administering devices, including: X X X X X X X X
(A) IV access devices; X X X X X X X X
(B) Intraosseous needles; X X X X X X X X
(C) Infusion control device; X X X X X X X X
(ii) Drugs and supplies necessary for adult and pediatric emergency care; X X X X X X X X
(e) Sterile surgical sets for standard emergency department procedures, including:                
(i) Thoracotomy set; X X X X X X X  
(ii) Chest tubes with closed drainage devices (except level V clinics); X X X X X X X X
(iii) Emergency transcutaneous airway set (except level V clinics); X X X X X X X X
(iv) Peritoneal lavage set; X X X X X X    
(f) Nasogastric tubes (except level V clinics); X X X X X X X X
(g) Ability to provide thermal control equipment, including:                
(i) Patient warming capability (except level V clinics); X X X X X X X X
(ii) Blood and fluid warming capability (except level V clinics); X X X X X X X X
(iii) Expanded scale thermometer capable of detecting hypothermia (except level V clinics); X X X X X X X X
(h) Immobilization devices, including:                
(i) Cervical injury immobilization devices; X X X X X X X X
(ii) Long-bone immobilization devices, including traction splints; and X X X X X X X X
(iii) Backboard; X X X X X X X X
(i) Other equipment:                
(i) Urinary bladder catheters (except level V clinics); X X X X X X X X
(ii) Infant scale for accurate weight measurement under twenty-five pounds; X X X X X X X X
(iii) Medication chart, tape, or other system to assure ready access to information on proper doses-per-kilogram for resuscitation drugs and equipment sizes for pediatric patients; X X X X X X X X
(iv) Two-way radio linked with EMS/TC vehicles; X X X X X X X X
(2) Have the following equipment, both adult and pediatric sizes, in the surgery department:                
(a) Cardiopulmonary bypass; X X            
(b) Ability to provide thermal control equipment for:                
(i) Patient warming and cooling; X X X X X X X  
(ii) Blood and fluid warming; X X X X X X X  
(c) Rapid infusion capability; X X X X X X X  
(d) Autologous blood recovery and transfusion; X X X X X X    
(e) Ability to provide bronchoscopic capability in the operating room; X X X X X X    
(f) Ability to provide endoscopes; X X X X X X X  
(g) Craniotomy set; X X X X        
(3) Have the following equipment, both adult and pediatric sizes, in the critical care unit:                
NOTE for level III pediatric: If your written scope of trauma service includes critical care services, then your service must meet the level II pediatric critical care equipment standards.           X    
NOTE for level IV: If your written scope of trauma service includes critical care services, then your service must meet the level III critical care equipment standards;             X  
(a) Airway control and ventilation devices, including:                
(i) Oral and nasopharyngeal airways; X X X X X      
(ii) Laryngoscopes with curved and straight blades; X X X X X      
(iii) Endotracheal tubes with stylets available; X X X X X      
(iv) Bag-valve-mask resuscitators; X X X X X      
(v) Ability to provide mechanical ventilator; X X X X X      
(vi) Noninvasive oximetry and capnometry; X X X X X      
(vii) Oxygen source with concentration controls; X X X X X      
(b) Suction devices, including:                
(i) Suction machine; X X X X X      
(ii) Suction catheters; X X X X X      
(iii) Tonsil tip suction; X X X X X      
(c) Cardiac devices, including:                
(i) Cardiac pacing capabilities; X X X X X      
(ii) Electrocardiograph; X X X X X      
(iii) Cardiac monitor with at least two pressure monitoring modules including cardiac output and hard copy recording and with capability to continuously monitor heart rate, respiratory rate, temperature; X X X X X      
(iv) Defibrillator; X X X X X      
(v) Portable transport monitor with ECG and pressure monitoring capability; X X X X X      
(vi) Blood pressure cuffs; X X X X X      
(vii) Doppler device; X X X X X      
(viii) Noninvasive blood pressure machine; X X X X X      
(d) Intravenous supplies, including:                
(i) Standard IV fluids and administration devices appropriate for pediatric patients including: X X X X X      
(A) IV catheters; X X X X X      
(B) Intraosseous needles; X X X X X      
(C) Infusion sets and pumps with micro-infusion capabilities; X X X X X      
(D) Infusion controllers; X X X X X      
(ii) Adult and pediatric dosages/dilutions of medications; X X X X X      
(e) Sterile surgical sets, including: X X X X X      
(i) Thoracotomy set; X X X X X      
(ii) Chest tubes; X X X X X      
(iii) Emergency surgical airway sets; X X X X X      
(iv) Peritoneal lavage set; X X X X X      
(f) Intracranial pressure monitoring devices; X X X X        
(g) Gastric supplies, including NG tubes; X X X X X      
(h) Ability to provide thermal control equipment, including:                
(i) Patient warming and cooling devices; X X X X X      
(ii) Blood and fluid warming device; X X X X X      
(iii) Expanded scale thermometer capable of detecting hypothermia; X X X X X      
(iv) Device for assuring warmth during transport; X X X X X      
(i) Other equipment, including:                
(i) Ability to provide patient weighing devices; X X X X X      
(ii) Cardiac emergency cart. X X X X X      




[Statutory Authority: RCW 70.168.060 and 70.168.070. 04-01-041, § 246-976-620, filed 12/10/03, effective 1/10/04. Statutory Authority: Chapter 70.168 RCW. 98-04-038, § 246-976-620, filed 1/29/98, effective 3/1/98.]