1. A. In addition to meeting the requirement of COMAR 30.08.11.05, the hospital shall:

   1. (1) Establish one or more acute stroke teams which shall respond to the emergency department with coordinated services for the effective delivery of emergency and acute stroke treatment;
   2. (2) Use the National Institutes of Health Stroke Scale (NIHSS) for the initial assessment of patients with acute stroke, with clinicians performing an NIHSS having documented training in the completion of the NIHSS; and
   3. (3) Perform ongoing neurological assessment on patients with acute stroke.

2. B. The acute stroke team shall include at a minimum:

   1. (1) A physician, with special competence in caring for the acute stroke patient, who is Board-certified or Board-eligible in:

      1. (a) Neurology;
      2. (b) Critical care medicine; or
      3. (c) Emergency medicine; and

   2. (2) At least one additional health care provider, with experience in caring for the acute stroke patient, who may be:

      1. (a) An emergency physician;
      2. (b) A neurology resident or fellow;
      3. (c) An internist;
      4. (d) A registered nurse;
      5. (e) A physician assistant; or
      6. (f) A nurse practitioner.

3. C. If a physician otherwise satisfies §B(1) of this regulation but is not Board-certified or Board-eligible in neurology, a Board-certified or Board-eligible neurologist shall be available within 15 minutes for consultation under the terms of a written agreement by:

   1. (1) Telephone; or
   2. (2) Audio/visual communication.

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

Effective date: October 17, 2011 (38:21 Md. R. 1280)

Chapter revised effective January 1, 2022 (48:22 Md. R. 938)