The hospital shall have an ED dedicated to pediatric care, including:

1. A. A designated and dedicated ED physician director and nurse manager;

2. B. A sufficient number of registered nurses and other clinicians who:

   1. (1) Have the necessary knowledge and skills to provide care during trauma resuscitation;
   2. (2) Are present to manage projected caseloads; and
   3. (3) Immediately reinforce the number of staff upon notice of multiple admissions;
3. C. Defined and agreed upon roles and responsibilities approved by the TMD to ensure availability of ED resources;
4. D. Verification of functioning life-safety emergency equipment and supplies organized for trauma resuscitation present and immediately available 24 hours a day;
5. E. An identified pediatric trauma resuscitation room with dedicated staff, equipment, and supplies 24 hours a day;
6. F. Designation by MIEMSS as a pediatric base station;
7. G. Policies and protocols for trauma team response and roles in ED trauma resuscitation in accordance with Regulation .20 of this chapter; and

8. H. Equipment for resuscitation of patients of all ages, including:

   1. (1) Airway management equipment and supplies including a “difficult airway cart”;

   2. (2) Emergency equipment located in the resuscitation area/ED for:

      1. (a) Thoracotomy;
      2. (b) Vascular access;
      3. (c) Thoracostomy or chest decompression;
      4. (d) Bedside ultrasound;
      5. (e) Extremity hemorrhage control devices/tourniquet; and
      6. (f) Rapid infuser and warmer;
   3. (3) Medications necessary for the resuscitation and emergency care of children with immediate capability for appropriate pediatric dosages based on weight in kilograms;
   4. (4) Printed pre-calculated pediatric drug dosage reference materials, including, but not limited to, charts, wall posters, and length-based dosage tapes;

   5. (5) The following monitoring devices:

      1. (a) ECG monitor/defibrillator capable of providing a hard copy rhythm strip, and with internal and external pediatric paddles capable of delivering from 0 to 360 joules;
      2. (b) Pulse oximeter with adult and pediatric probes;
      3. (c) Blood pressure cuffs in infant, child, adult, and thigh sizes;
      4. (d) Thermometer probe capable of reading from 28 to 42 degrees centigrade;
      5. (e) Otoscope;
      6. (f) Ophthalmoscope;
      7. (g) Transport monitor with pediatric capabilities;
      8. (h) Doppler and noninvasive blood pressure monitoring devices for infant, child, and adult;
      9. (i) End-tidal carbon dioxide monitor; and
      10. (j) Pressure monitor for central venous pressure and arterial line pressure;
   6. (6) Standard intravenous fluids and administration devices, including large-bore intravenous catheters;
   7. (7) Newborn resuscitation supplies;
   8. (8) Compartmental pressure measuring devices immediately available; and
   9. (9) Cervical and skeletal traction devices immediately available.

Authority: Education Article, §13-509, Annotated Code of Maryland

Effective date: September 7, 1998 (25:18 Md. R. 1439)

Regulation .01B amended effective July 1, 2002 (29:12 Md. R. 933)

Regulation .03E amended effective June 4, 2007 (34:11 Md. R. 972)

Regulation .06C amended effective July 1, 2002 (29:12 Md. R. 933)

Regulation .16A amended effective July 1, 2002 (29:12 Md. R. 933)

Regulation .16 amended effective June 4, 2007 (34:11 Md. R. 972)

Regulation .18A amended effective July 1, 2002 (29:12 Md. R. 933)

Regulations .01—.20 repealed and new regulations .01 — .22 adopted effective July 24, 2023 (50:14 Md. R. 594)

Regulation .02B amended effective July 21, 2025 (52:14 Md. R. 714)