ASTM_F_1286_-_90_2002.pdf

Designation:F 1286 90(Reapproved 2002)Standard Guide forDevelopment and Operation of Level 1 Pediatric TraumaFacilities1This standard is issued under the fixed designation F 1286;the number immediately following the designation indicates the year oforiginal adoption or,in the case of revision,the year of last revision.A number in parentheses indicates the year of last reapproval.Asuperscript epsilon(e)indicates an editorial change since the last revision or reapproval.1.Scope1.1 This guide establishes minimum guidelines for thedevelopment and operation of a pediatric trauma facility in achildrens or general hospital.A pediatric trauma facility is aninstitution whose medical and administrative leadership hasexpressed the personal,institutional,and financial commitmentto optimal care of the injured child 24 h a day,365 days a year.1.2 This guide defines the system,organizational structure,clinical personnel,and physical equipment necessary for apediatric trauma facility,whether freestanding or a jointadult/pediatric facility in either a childrens hospital or generalhospital committed to the care of injured children.1.3 The criteria outline in this guide incorporates levels ofcategorization and their essential or desired characteristics.2.Referenced Documents2.1 ASTM Standards:F 1224 Guide for Providing System Evaluation for Emer-gency Medical Services23.Terminology3.1 Definitions:3.1.1 trauma care systema coordinated network of emer-gency medical systems(EMS)comprised of one or moretrauma centers linked by triage protocols,appropriate commu-nications,transportation services,and prehospital care tomanage effectively the injured child from initial injury tocomplete rehabilitation.The trauma care system is a subsystemwithin the EMS system.3.1.2 trauma centera hospital that has made the institu-tional commitment to fulfill all criteria outlined in Sections 1through 4 and where available be designated by the appropriateauthority.3.2 Definitions of Terms Specific to This Standard:3.2.1 pediatric patienta patient whose morphologicgrowth potential has not been completed.In general,a patientless than 15 years old or consistent with local practice.4.Significance and Use4.1 The purpose of this guide is to provide guidelines forcategorizing pediatric trauma centers to ensure consistency ofpediatric trauma care throughout the nation.The guidelineswill form the quantitative basis for audit and ongoing qualityassurance.4.2 This guide can be used in conjunction with objectivequality assurance outcome measures as outlined in GuideF 1224.4.3 This guide can be used by local,regional,and nationalauthorities to establish pediatric trauma centers.5.Implementation of Pediatric Trauma Facilities5.1 The implementation of a pediatric trauma facility des-ignation will be conducted consistent with the regulation oflocal,state,and federal government authorities having juris-diction for this process.5.2 The most significant ingredient necessary for optimalcare of the pediatric trauma patient is commitment,bothpersonal and institutional.For the institutions,optimal caremeans providing capable personnel who are immediatelyavailable,sophisticated equipment,services that are frequentlyexpensive to purchase and maintain,and priority of access tolaboratory,radiology,operating suites,and intensive carefacilities and services.For the medical and nursing staff,optimal care means a commitment to the concept of adequatestaffing,prompt availability,continuing education,and qualityassurance.5.3 It is recognized that a Level I pediatric trauma centershould be located in a facility providing comprehensive carefor children.The institutions must demonstrate a continuingcommitment to a high level of pediatric trauma care.Methodsof demonstrating the commitment to the trauma system shallinclude,but not be limited to,a broad resolution that thehospital governing body agrees to do the following:5.3.1 Participate in the operations and integration of aregional or statewide system,to ensure pediatric patient caredata for system management,quality assessment,and opera-tions research,5.3.2 Establish policy and procedures for the maintenanceof services essential for a trauma center/system,1This guide is under the jurisdiction of ASTM Committee F30 on EmergencyMedical Services and is the direct responsibility of Subcommittee F30.03 onOrganization/Management.Current edition approved July 9,1990.Published August 1990.2Annual Book of ASTM Standards,Vol 13.02.1Copyright ASTM International,100 Barr Harbor Drive,PO Box C700,West Conshohocken,PA 19428-2959,United States.5.3.3 Ensure that all pediatric trauma patients will receivemedical care to the level of the institutions accreditation,and5.3.4 Establish a priority admission for the pediatric traumapatient to the full services of the institution,including adequateresuscitation facilities and personnel,operating room availabil-ity,and intensive care unit availability.The Level I pediatrictrauma center must assume the respo