2818.1 Level I facilities shall have transfer agreements with other hospitals acting as receiving facilities.

2818.2 Level II facilities shall have transfer agreements as transferring and receiving facilities.

2818.3 Once it is apparent that interhospital transfer is in the patient's best interest, the treating physician shall ensure that the patient is optimally stabilized within the capabilities of the transferring institution. Measures shall be taken to stabilize each injury or physiologic derangement, such as respiratory distress or shock, before the transfer. The urgent needs of the patient who requires advance level trauma care shall supersede the requirement that patients be cared within a specific provider network.

2818.4 Transferring physician responsibilities shall include:

1. (a) Identifying the patient needing transfer;
2. (b) Initiating the transfer process by direct contact with the receiving surgeon or physician;
3. (c) Initiating resuscitation measures within the capabilities of the facility;
4. (d) Determining the appropriate mode of transportation in consultation with the receiving surgeon or physician; and
5. (e) Transferring all records, results, and x-rays to the receiving facility.

2818.5 Receiving physician responsibilities shall include:

1. (a) Ensuring resources are available at the receiving facility;
2. (b) Providing advice or consultation regarding specifics of the transfer or additional evaluation or resuscitation prior to transport;
3. (c) Clarifying and identifying medical control after the receiving facility agrees to accept the patient; and
4. (d) Identifying a process for transportation, allowing feedback from the receiving physician to the transport team directly or to the medical direction of the transport team.

2818.6 Management during transport of patient:

(a) Qualified personnel and equipment shall be available during transport to meet anticipated contingencies;

(b) Sufficient supplies shall accompany the patient during transport, such as intravenous (IV) fluids, blood, and appropriate medications;

(c) Vital functions shall be equally monitored;

(d) Vital functions shall be supported; for example, hemodynamics, ventilation, central nervous system, and spinal protection;

(e) Records shall be kept during transport; and

(f) Communication shall be kept with on-line medical direction during transport.

SOURCE: Notice of Final Rulemaking published at 46 DCR 8779 (October 29, 1999); as amended by Notice of Emergency and Proposed Rulemaking published at 51 DCR 3933 (April 16, 2004) [EXPIRED]; as amended by Final Rulemaking published at 51 DCR 7277 (July 23, 2004).