Code of Maryland Regulations
Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS)
Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS
Chapter 30.08.09 - Eye Trauma Center Standards
Section 30.08.09.04 - Facility

Universal Citation: MD Code Reg 30.08.09.04

Current through Register Vol. 51, No. 19, September 20, 2024

A. Ophthalmic Treatment Area. The hospital shall have:

(1) An ophthalmic treatment area that is identified for and dedicated to the examination of ophthalmic emergencies;

(2) A medical director of the eye trauma center to oversee the management of the ophthalmic treatment area;

(3) A nurse manager responsible for the ophthalmic treatment area;

(4) Organized equipment and supplies to care for eye trauma, including:
(a) A slitlamp biomicroscope;

(b) An indirect ophthalmoscope;

(c) A visual acuity chart (that is, Snellen and near chart);

(d) Color plates, either Ishihara, or Hardy-Rand-Rittler;

(e) Applanation Tonometry (that is, Tonopen, iCare®); and

(f) Diagnostic ophthalmic lenses for gonioscopy and ophthalmoscopy;

(5) The following readily available medications necessary for the treatment and diagnosis of ophthalmic emergencies (in the event of regional or national drug shortages, pharmacy will assist with sourcing of appropriate, alternative options):
(a) Systemic eye pressure lowering medications;

(b) Topical intraocular pressure lowering medications of different classes;

(c) Mydriatic and cycloplegic drops;

(d) Topical anesthetics, such as proparacaine and tetracaine; and

(e) Fluorescein drops or strips;

(6) Sterile surgical sets specifically for ophthalmic trauma care readily available and located in the ophthalmic treatment area, including:
(a) Vitreous tap and inject equipment;

(b) Lateral canthotomy set;

(c) Ocular lavage set-up; and

(d) pH strips;

(7) Equipment for skin laceration repair;

(8) The following equipment:
(a) Laser iridotomy (YAG or Argon);

(b) Argon laser for retinopexy;

(c) Cryoprobe available for retinopexy; and

(d) Either of the following equipment for pneumatic retinopexy:
(i) SF6, or

(ii) C3 F8 gas; and

(e) Corneal foreign body removal equipment such as 27-30 gauge needle and corneal burr;

(9) Pharmacy support available to obtain intravitreal antimicrobial medications and steroids within 1 hour, 24 hours a day; and

(10) Pharmacy support available to obtain topical fortified antimicrobial medications within 1 hour, 24 hours a day.

B. Operating Room (OR). The hospital shall have an OR:

(1) With adequately trained staff in ophthalmic surgery available with 1-hour response for ophthalmic emergencies 24 hours a day as needed per eye trauma center policies and procedures;

(2) Available ophthalmic surgery within 1 hour of notice; and

(3) With operating microscope equipment readily available for:
(a) Vitreoretinal surgery,

(b) Oculoplastic surgery;

(c) Anterior segment surgery; and

(d) Pediatric patients.

C. The hospital shall have an inpatient unit available with inpatient beds with nursing staff who have knowledge and skills specific for the care of post-operative patients.

D. Ongoing care management and disposition of care may be integrated into the outpatient setting as indicated.

E. A hospital shall have CT scan and ocular echography available 24 hours a day.

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