New Mexico Administrative Code
Title 7 - HEALTH
Chapter 27 - EMERGENCY MEDICAL SERVICES
Part 7 - TRAUMA CARE SYSTEM
Section 7.27.7.7 - DEFINITIONS

A. "ACLS" means advanced cardiac life support, a course developed by the American Heart Association.

B. "activation of the trauma system" means procedures whereby a pre-hospital provider of hospital/healthcare facility identifies the major trauma patient by trauma triage criteria and pre-hospital and hospital resources are mobilized to care for the patient in accordance with the regional trauma plan and the trauma center's policy and procedures for trauma team activation.

C. "approved" means approved by the IPEMS Bureau.

D. "ATLS" means advanced trauma life support, a course developed by the American College of Surgeons.

E. "board certified or board eligible" means completion of the examination and award of certification by the appropriate certifying body for the physician specialty. Eligible means meets the standards to sit for the appropriate certifying board and actively pursuing certification.

F. "BP" means blood pressure.

G. "Bureau" means the Injury Prevention and EMS Bureau of the Public Health Division of the Department of Health.

H. "certified ambulance service" means any provider of ambulance service subject to the jurisdiction of the Public Regulation Commission.

I. "continuum of care" means all services available to the population of persons either at risk of injury or who have incurred an injury, beginning with injury prevention and progressing to long term care services and including the return to the highest level of wellness and functioning.

J. "CME" means continuing medical education.

K. "Department" means the New Mexico Department of Health.

L. "designated trauma center" means a hospital identified by the Department as a Level I, II, III, or IV trauma care services provider.

M. "designation" means a formal determination by the Department that a hospital/healthcare facility is capable of providing special resources and care as a designated trauma center.

N. "Emergency Medical Services (EMS) Provider" means Emergency Medical Technicians (EMT) or trained EMS first responders who render care in response to a need for immediate medical care to prevent loss of life or aggravation of physical or psychological illness or injury.

O. "ENPC" means Emergency Nursing Pediatric Course, developed by the Emergency Nurses Association.

P. "E-Code" means external cause code, an etiology included in the International Classification of Diseases (ICD).

Q. "ED" means emergency department.

R. "facility patient care protocols" means the written procedures adopted by the medical staff of a participating facility that directs the care of the patient. These procedures shall be based upon the assessment of the patient's medical needs and shall follow minimum statewide standards.

S. "hospital" means a facility with an emergency department and physician(s) available, licensed under state statute, or a comparable facility operated by the federal government or located and licensed in another state.

T. "hospital trauma registry" means a computerized trauma data base maintained by a hospital/healthcare facility.

U. "hospital trauma registry policy manual" means a written guideline used by New Mexico trauma data collection personnel to ensure uniform, complete and accurate trauma data.

V. "ICD" means the international classification of diseases, a coding system developed by the World Health organization.

W. "ICU" means intensive care unit.

X. "immediately available" means the immediate and rapid response upon notification and the physical presence of the health professional in the stated location at the time of need by the trauma patient which is continuously monitored by the process improvement plan.

Y. "inclusive trauma system" means a trauma system that encourages optimal participation by all providers in the continuum of trauma care as well as injury prevention, rehabilitation and long-term care service providers.

Z. "indicator" means a process improvement tool or process measure used to monitor the quality of important governance, management, clinical, and support processes and outcomes.

AA. "interfacility transfer criteria" means the criteria established to indicate the need for a level of care for the trauma patient that is not available at the transferring facility.

BB. "letter of intent" means a written document executed by a hospital/healthcare facility's administration indicating their intention to participate in the New Mexico Trauma System.

CC. "level I trauma center" means a hospital which is designated by the Department as having met the hospital/healthcare facility resource standards for a level I trauma center as described in the most recent version of the Resources for Optimal Care of the Injured Patient, published by the Committee on Trauma of the American College of Surgeons. A level I trauma center is capable of providing immediately available comprehensive care on a twenty-four (24) hour basis for acutely injured patients of all ages. The hospital is committed with resources for the evaluation, stabilization, and definitive care of all injured patients as well as committed to trauma-related research, training, and community outreach. A level I trauma center shall satisfy the requirements for outreach, training and public education as specified in Appendix D, Table 1, Outreach, Training and Public Education Section.

DD. "level II trauma center" means a hospital which is designated by the Department as having met the hospital resource standards for a level II trauma center as described in the most recent version of the Resources for Optimal Care of the Injured Patient, published by the Committee on Trauma of the American College of Surgeons. A level II trauma center is capable of providing promptly available major trauma care on a twenty-four (24) hour basis for acutely injured patients of all ages. The hospital has the capability to provide subspecialty care in most areas and is committed with resources for the evaluation, stabilization, and definitive care of all injured patients. A level II trauma center shall satisfy the requirements for outreach, training and public education as specified in Appendix D, Table 1, Outreach, Training and Public Education Section.

EE. "level III trauma center" means a hospital which is designated by the Department as having met the hospital resource standards for a level III trauma center as described in Appendix D, Table 1 of these regulations. A level III trauma center is capable of providing promptly available trauma care on a twenty-four (24) hour basis, including on-call general surgery and select specialty coverage. The hospital is capable of providing evaluation, initial stabilization, limited ongoing care and for the transfer of acutely injured patients of all ages to level I or level II facilities which can provide further definitive surgical care.

FF. "level IV trauma center" means a hospital or other healthcare facility that is designated by the Department as having met the hospital/healthcare facility resource standards for a level IV trauma center as described in Appendix D, Table1 of these regulations. A level IV trauma center is capable of providing physician-directed basic services for the evaluation, initial stabilization, and early transfer of acutely injured patients of all ages to a higher level of care. Such facilities may have limited on-call general surgical and subspecialty services.

GG. "local EMS medical director" means a physician who is responsible for all aspects of patient care of a local EMS system or EMS provider service, including providing for or ensuring the medical control of EMTs; the development, implementation, and evaluation of protocols and oversight of process improvement activities as described in the Medical Direction for Emergency Medical Services, 7.27.3 NMAC, or such other regulations as may be adopted by the Public Health Division of the Department.

HH. "local trauma transport protocols" means protocols, developed and approved by the Regional Trauma Advisory Councils, to define destination procedures for major trauma patients.

II. "major trauma" means serious injury caused by external forces which may result in death or disability.

JJ. "mid-level practitioner" means an advance practice nurse or physician assistant.

KK. "New Mexico Trauma Foundation" means an organization established to conduct trauma related research, to develop and coordinate trauma injury prevention programs, to coordinate and facilitate the financial viability activities of the designated trauma centers and trauma team participating physicians and other trauma system related activities and purposes.

LL. "Office of the Medical Investigator (OMI)" means the office designated by the State of New Mexico to determine the causes of sudden or unexplained death.

MM. "PALS" means pediatric advance life support, a course developed by the American Heart Association.

NN. "participating facility" means any hospital that treats or admits trauma patients and that is an active participant in their Regional Trauma Advisory Council.

OO. "pediatric trauma patient" means a trauma patient known or estimated to be less than fourteen (14) years of age.

PP. "physician" means a doctor of medicine or osteopathy who is licensed or otherwise authorized to practice medicine or osteopathy in the State of New Mexico.

QQ. "PI" means process improvement, an organized method of monitoring, evaluating and improving care provided throughout the trauma system.

RR. "pre-hospital patient care protocols" means the written procedures adopted by the local EMS medical director or adopted by the Regional Trauma Council which directs the pre-hospital emergency care of a patient.

SS. "promptly available" means the physical presence of the health professionals in the stated location within a specified period of time, which is defined in the local or regional trauma plan and the hospital's trauma center designation application.

TT. "qualifying trauma patient" means a patient who meets the statewide and approved regional pre-hospital trauma triage criteria and the Bureau approved criteria for statewide trauma registry inclusion.

UU. "recognized" means written acknowledgement by the Bureau.

VV. "region" means a geographic area served by local emergency medical service(s) and/or hospital(s)/healthcare facilities for the purpose of planning a local system which provides care for persons with injuries.

WW. "Regional Trauma Advisory Council (ReTrAC)" means a TAC and Bureau approved group from each recognized trauma region that develops and implements trauma plans that address the particular needs of the trauma service area.

XX. "regional trauma plan" means a document created by a Regional Trauma Advisory Council and approved by the Bureau with the advice of the Trauma Advisory Committee that identifies goals, objectives, guidelines, and standards for the oversight, management and operation of a regional trauma program.

YY. "Secretary" means the Secretary of the New Mexico Department of Health.

ZZ. "trauma" means a major single or multi-system injury requiring immediate medical or surgical intervention or treatment to prevent death or permanent disability.

AAA. "Trauma Advisory Committee (TAC)" means the subcommittee on trauma of the Statewide EMS Advisory Committee established pursuant to the EMS Act.

BBB. "trauma center" means a hospital/healthcare facility designated by the Department to receive and provide services for trauma patients under these regulations.

CCC. "trauma clinical services" means the pre-hospital coordination, hospital resuscitation, hospital inpatient treatment, rehabilitation and follow-up medical care services for trauma patients which are the responsibility of the designated trauma center and the appropriate physician specialist, as defined by these regulations.

DDD. "trauma committee" means a multi-disciplinary, hospital-sponsored committee that meets regularly to provide input to the trauma program and to the hospital's administrative and medical staff.

EEE. "trauma nurse coordinator" means a registered nurse with experience, special training and certification who is assigned by the trauma center to manage the requirements as provided for in these regulations and to provide trauma program coordination, leadership and direction according to a hospital-approved job classification.

FFF. "trauma program" means an administrative unit of a trauma center that includes the medical director, trauma nurse coordinator, and trauma program support staff, for the ongoing management and coordination of the hospital's trauma program.

GGG. "TTP" means the approved prehospital trauma transport protocols, developed by the local/regional EMS medical director, that utilize the trauma triage guidelines to determine primary and alternative transport destinations for prehospital providers.

HHH. "trauma registry" means a database which documents and integrates medical and system information related to the provision of trauma care by hospitals/healthcare facilities.

III. "trauma surgeon" means a physician who is Board certified or Board eligible in general surgery, and who has trauma surgery privileges delineated by the hospital/healthcare facility's medical staff.

JJJ. "trauma system" means an organized approach to providing personnel, trauma centers, and equipment for the coordinated and effective treatment of patients with an injury with the potential of requiring immediate medical or surgical intervention to prevent death or disability. The trauma care system includes prevention activities, pre-hospital care, hospital care, and rehabilitation. The components of a trauma system include:

KKK. "trauma system plan" means the State Trauma Plan that develops the infrastructure needed to support an inclusive statewide trauma system that recognizes the unique geo-political attributes of the regions and empowers the Regional Trauma Councils (ReTrACs) to meet the needs of their regions.

LLL. "trauma team" means personnel assigned for involvement with trauma resuscitation.

MMM. "trauma team physician" means a physician who has been identified by the designated trauma center and its trauma surgeon(s) as a member of the center's trauma team.

NNN. "trauma triage criteria" means the parameters established to identify the high-risk patients for major injury and/or critically injured trauma patients for treatment in accordance with the local trauma transport protocols. The criteria shall include such considerations as the anatomic components, physiologic conditions, and mechanism of injury.

OOO. "triage" means the sorting of trauma patients in terms of disposition, destination, or priority requiring and identifying injury severity and patient risk, so that the appropriate care level can be readily accessed according to patient care guidelines.