1224.33.3 Basic Emergency Medical Service

When 24-hour basic emergency service is to be provided, at a minimum, all the provisions of Standby Emergency Service under Section 1224.33.2 and the following shall be provided:

In addition to the requirements of Section 1224.33.2.1 the emergency entrance shall have direct access from public roads for ambulance and vehicle traffic conforming with the requirements of the local authorities having jurisdiction. Entrance and driveway shall be clearly marked. If a raised platform is used for ambulance discharge, provide a ramp for pedestrian and wheelchair access.

Paved emergency access shall be provided to permit discharge of patients from automobiles and ambulances, and temporary parking convenient to the entrance.

This area shall be located to permit staff observation and control of access to treatment areas, pedestrian and ambulance entrances, and public waiting area.

Storage for wheelchairs and gurneys for arriving patients shall be located out of circulation paths with access to emergency entrances.

A public waiting area shall be provided in compliance with Section 1224.4.5 and include provision of public toilet room(s), drinking fountains, and telephone adjacent to the waiting area, dedicated to, and within, the Emergency Service Space.

Examination and treatment rooms shall meet the requirements under Section 1224.33.2.2.

These rooms are for emergency procedures, including emergency surgery, and shall have at least 250 square feet (23.23 m²) of clear floor space. A minimum clearance of 5 feet (152 mm) shall be provided around all sides of the procedure table or gurney. Each room shall have cabinets and emergency supply shelves, image viewing capability, examination lights, and counter space for writing. Additional space with cubicle curtains for privacy may be provided to accommodate more than one patient at a time in the trauma room with a minimum clear floor area of 200 square feet (18.58 m²) for each patient bay defined by the privacy curtains. There shall be storage provided for immediate access to attire used for universal precautions. Doors leading from the ambulance entrance to the cardiac trauma room shall have an opening with a minimum width of 5 feet (1524 mm). At least one scrub sink shall be located outside the entrance to each trauma room. One scrub station consisting of two scrub positions is permitted to serve two trauma rooms if located adjacent to the entrance of each procedure room. The placement of scrub sinks shall not restrict the minimum required corridor width.

At least one orthopedic or cast room shall be provided within the emergency service space. Provisions shall include storage for splints and other orthopedic supplies, traction hooks, image viewing capability, and examination lights. If a sink is used for the disposal of plaster of paris, a plaster trap shall be provided. The clear floor space for this area shall be a minimum of 180 square feet (16.7 m²)

Communication connections shall be provided as required under Section 1224.33.2.6. The communications center may be a part of the staff work and charting area.

Equipment and supply storage shall be provided as required under Section 1224.33.2.3.

A patient toilet room with a lavatory shall be immediately accessible to the treatment room(s). Where there are more than eight treatment stations, a minimum of two toilet rooms, with a lavatory in each toilet room, shall be required.

Provide rooms for clean, soiled or used supplies.

See Section 1224.4.4.7. This room is for the exclusive use of the emergency service space.

See Section 1224.4.4.6.

These areas shall have space for counters, cabinets, and medication storage, and shall be provided with handwashing stations. They may be combined with or include centers for reception and communication.

A staff lounge shall be located within the Emergency Department and include staff clothing change areas with lockers, showers, toilets and handwashing stations for male and female staff.

A housekeeping room, compliant with Section 1224.4.15, shall be located within the unit and dedicated to the emergency service space.

If provided shall comply with the requirements of Section 1224.4.4.1.3.

When a secure holding room is provided, it shall meet the following requirements. The location of the secure holding room(s) shall facilitate staff observation and monitoring of patients in these areas. The secure holding room shall have a minimum clear floor area of 60 square feet (5.57 square meters) with a minimum wall length of 7 feet (2.13 meters) and a maximum wall length of 11 feet (3.35 meters). This room shall be designed to prevent injury to patients:

1. All finishes, light fixtures, vents, diffusers, and fire protection/alarm components shall be tamper resistant and ligature resistant.
2. There shall not be any electrical outlets, medical gas outlets, or similar devices.
3. There shall be no sharp corners, edges, or protrusions, and the walls shall be free of objects or accessories of any kind.
4. Patient room doors shall swing out and shall have hardware on the exterior side of the door only. The minimum width shall be 44 inches (1120 mm).
5. A small impact-resistant view panel or window shall be provided in the door for discreet staff observation of the patient.