SECTION 310:667-29-1. Emergency service or department

(a)   General. The hospital shall have procedures for the treatment of emergency cases. The hospital may meet this requirement through an organized emergency service department or by establishing emergency protocols. Appropriate emergency signage shall be displayed when the hospital has an organized service or department.

(b)   Organization and direction. The department or service shall be directed by qualified personnel and integrated with other departments of the hospital.

(1)   There shall be written policies which shall be enforced to control emergency room procedures. Hospitals that do not offer maternity service shall have policies and procedures for treatment of this type of patient.

(2)   The policies and procedures governing medical care provided in the emergency service or department shall be established. This shall be a continuing responsibility of the medical staff.

(3)   The emergency service shall be supervised by a qualified member of the medical staff. Nursing functions shall be the responsibility of a registered nurse.

(4)   The administrative functions shall be a responsibility of a member of the hospital administration.

(c)   Facilities. Facilities shall be provided to assure prompt diagnosis and emergency treatment.

(1)   Facilities shall be separate and independent of the operating rooms.

(2)   The location of the emergency service shall be in close proximity of an exterior entrance of the hospital.

(3)   Diagnostic and treatment equipment, drugs, supplies, and space, including a sufficient number of treatment rooms, shall be adequate in terms of the size and scope of services provided. An obstetrics pack and supplies shall be available at all times in the emergency room. A cardiac defibrillator and monitoring equipment shall be available to the emergency services.

(4)   The emergency room shall be equipped with a base station radio using medical frequencies VHF 155.340 or UHF Medical Channels 1 through 10 and/or compatible frequencies with ambulance services operating in the area. The emergency room staff shall use this equipment to communicate with all emergency medical vehicles and relay the information from emergency medical personnel to the emergency room physician and/or nurse.

(d)   Medical and nursing personnel. There shall be adequate medical and nursing personnel available at all times.

(1)   The hospital shall be responsible for insuring adequate medical coverage for emergency services.

(2)   Qualified physicians or licensed independent practitioners shall be regularly available at all times for the emergency service, either on duty or on call. If a physician or licensed independent practitioner is on call, he or she shall be able to present at the emergency room within twenty (20) minutes.

(3)   A physician or licensed independent practitioner shall be responsible for all patients who arrive for treatment in the emergency service.

(4)   Registered nurses shall be available on site at all times and in sufficient number to deal with the number and extent of emergency services.

(e)   Medical records. Adequate medical records on every patient shall be kept.

(1)   The emergency room record contains:

(A)   Patient identification.

(B)   Time and means of injury.

(C)   History of disease or injury.

(D)   Medication history and drug allergies.

(E)   Physical findings.

(F)   Laboratory and x-ray reports, if any.

(G)   Diagnosis and therapeutic orders.

(H)   Record of treatment including vital signs.

(I)   Disposition of the case.

(J)   Signature of the registered nurse.

(K)   Signature of the non-physician practitioner, if applicable.

(L)   Signature of the physician.

(M)   Documentation if the patient left against medical advice.

(2)   Medical records for patients treated in the emergency service shall be organized by personnel from medical records department in accordance with facility policy.

(3)   Where appropriate, medical records of emergency services shall be integrated with those of the inpatient and outpatient services.

(4)   A proper method of filing records shall be maintained.

(f)   Drug and medication distribution and control. Drugs in the emergency department shall be securely maintained and controlled by staff at all times. If the department does not have staff present at all times, all drugs shall be secured in sealed storage with devices placed to denote tampering. All Schedule II drugs shall be stored as specified in OAC 310:667-21-8(c). All drugs shall be administered and dispensed as required by state law.

[Source: Added at 12 Ok Reg 1555, eff 4-12-95 (emergency); Added at 12 Ok Reg 2429, eff 6-26-95; Amended at 20 Ok Reg 1664, eff 6-12-03]