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RULE §131.46Emergency Services

(a) A facility shall provide to each patient, without regard to the individual's ability to pay, an appropriate medical screening, examination, and stabilization within the facility's capability, including ancillary services routinely available to the facility, to determine whether an emergency medical condition exists and shall provide any necessary stabilizing treatment.

(b) The organization of the emergency services shall be appropriate to the scope of the services offered. The services shall be organized under the direction of a qualified physician member of the medical staff who is the medical director or clinical director.

(c) A facility shall maintain patient medical records for all emergency patients. The medical records shall contain patient identification, complaints, name of physician, name of nurse, time admitted to the emergency suite, treatment, time discharged, and disposition.

(d) Personnel.

  (1) There shall be adequate medical and nursing personnel qualified in emergency care to meet the written emergency procedures and needs anticipated by the facility.

  (2) There shall be on duty and on site at all times at least one person qualified as determined by the medical staff to initiate immediate appropriate lifesaving measures; and at least one nurse with current advanced cardiac life support and pediatric advanced life support certification.

  (3) Qualified personnel must be physically present in the emergency treatment area at all times.

  (4) One or more physicians shall be on-site at all times during facility hours of operation.

  (5) Schedules, names, and telephone numbers of all physicians and others on emergency call duty, including alternates, shall be maintained. The facility shall retain the schedules for at least one year.

(e) Adequate age-appropriate supplies and equipment shall be available and in readiness for use. Equipment and supplies shall be available for the administration of intravenous medications as well as facilities for the control of bleeding and emergency splinting of fractures. The emergency equipment shall be periodically tested according to the policy adopted, implemented, and enforced by the hospital.

(f) At a minimum, the age-appropriate emergency equipment and supplies shall include the following:

  (1) emergency call system;

  (2) oxygen;

  (3) mechanical ventilatory assistance equipment, including airways, manual breathing bag, and mask;

  (4) cardiac defibrillator;

  (5) cardiac monitoring equipment;

  (6) laryngoscopes and endotracheal tubes;

  (7) suction equipment;

  (8) emergency drugs and supplies specified by the medical staff;

  (9) stabilization devices for cervical injuries;

  (10) blood pressure monitoring equipment; and

  (11) pulse oximeter or similar medical device to measure blood oxygenation.

(g) Facilities shall participate in the local Emergency Medical Service (EMS) system, based on the facility's capabilities and capacity, and the locale's existing EMS plan and protocols.

(h) Emergency services for sexual assault survivors. The facility shall develop, implement, and enforce policies and procedures to ensure after a sexual assault survivor presents to the facility following a sexual assault, the facility shall provide the care specified under Health and Safety Code, Chapter 323.

Source Note: The provisions of this §131.46 adopted to be effective June 1, 2010, 35 TexReg 4400; amended to be effective February 2, 2020, 45 TexReg 554

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