California Code of Regulations
Title 22 - Social Security
Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies
Chapter 1 - General Acute Care Hospitals
Article 6 - Supplemental Services
Section 70453 - Comprehensive Emergency Medical Service General Requirements

(a) Written policies and procedures shall be developed and maintained by the person responsible for the service in consultation with other appropriate health professionals and administration. Policies shall be approved by the governing body. Procedures shall be approved by the administration and medical staff where such is appropriate.

(b) The responsibility and the accountability of the emergency medical service to the medical staff and administration shall be defined.

(c) The emergency medical service shall be so located in the hospital as to have ready access to all necessary services.

(d) A communications system employing telephone, radiotelephone or similar means shall be in use to establish and maintain contact with the police department, rescue squads and other emergency services of the community.

(e) The emergency medical service shall have a defined emergency and mass casualty plan in concert with the hospital's capabilities and the capabilities of the community served.

(f) The hospital shall require continuing education of all emergency medical service personnel.

(g) Medical records shall be maintained on all patients presenting themselves for emergency medical care. These shall become part of the patient's hospital medical record. Past hospital records shall be available to the emergency medical service.

(h) An emergency room log shall be maintained and shall contain at least the following information relating to the patient: name, date, time and means of arrival, age, sex, record number, nature of complaint, disposition and time of departure. The name of those dead on arrival shall also be entered in the log.

(i) All medications furnished to patients through the emergency service shall be provided by a pharmacist or an individual lawfully authorized to prescribe. Such medications shall be properly labeled and all required records shall be maintained in accordance with state and federal laws.

(j) Each comprehensive emergency medical service shall be identified to the public by an exterior sign, clearly visible from public thoroughfares. The wording of such signs shall state: COMPREHENSIVE EMERGENCY MEDICAL SERVICE PHYSICIAN ON DUTY.

(k) Standardized emergency nursing procedures shall be developed by an appropriate committee of the medical staff.

(l) A list of referral services shall be available in the emergency center. This list shall include the name, address and telephone number of the following:

(m) The hospital shall have the following additional services which shall be continuously staffed in a manner that permits the performance of all required functions:

(n) The radiological service shall have the capability of performing contrast studies including angiography in addition to its usual capabilities.

(o) The clinical laboratory shall be capable of performing blood gas analysis, pH, serum electrolytes and other procedures appropriate for emergency medical care.

(p) Surgical services shall be immediately available for life-threatening situations.

(q) The hospital shall have readily available the service of a blood bank containing common types of blood and blood derivatives. Blood storage facilities shall be in or adjacent to the emergency service.

(r) There shall be affiliation of the emergency medical service with a medical school.

(s) Periodically, an appropriate committee of the medical staff shall evaluate the services provided and make appropriate recommendations to the executive committee of the medical staff and administration.