1224.33.2 Standby Emergency Medical Service

If provided, initial emergency management shall be provided in a specifically designated area of the hospital which shall include the following elements:

A well-marked, illuminated and covered entrance, at grade level. The emergency vehicle entry cover shall provide shelter for both the patient and the emergency medical crew during transfer from an emergency vehicle into the building. This exterior entrance shall not be substituted for the required accessible entrance to the hospital, protected from the weather by canopy or roof overhang assigned for passengers loading zone. Ambulance entrances shall provide a minimum of 6 feet (183 mm) in clear width to accommodate bariatric stretchers, mobile patient lift devices, and accompanying attendants. Reception shall be located to permit staff observation and control of access to treatment area, pedestrian and ambulance entrances, and public waiting area.

Standby emergency service shall include at least one treatment room with the following elements:

1. The area shall not be less than 120 square feet (11.15 m²) of clear floor area, exclusive of toilet room(s), waiting area and storage.
2. Each treatment room shall contain an examination light, work counter, and handwashing station.
3. Medical equipment, cabinets, medication storage and counter space for writing.
4. The dimensions and arrangement of treatment rooms shall be such that there is a minimum of 3 feet (914 mm) between the sides and foot of the bed/gurney and any wall or any other fixed obstruction. The treatment room may have additional space and provisions for several patients with cubicle curtains for privacy.
5. Multiple-station treatment rooms shall provide a minimum of 80 square feet (7.43 m²) per patient gurney, with a minimum 8 foot width (2,438 mm) and 3 feet (914 mm) at the foot of the bed/gurney, with a minimum of 3 feet to any wall or fixed obstruction, and a minimum of 5 feet (1524 mm) between patient gurneys. Patient gurneys shall be separated from adjoining cubicles by curtains. Handwashing fixtures shall be provided for each four treatment stations and for each major fraction thereof in multiple-station areas. These shall be uniformly distributed to provide equal access from each patient station.

Exception: Where renovation of existing treatment rooms is undertaken in facilities approved under the 2001 or prior California Building Code, existing treatment rooms may be renovated, or replaced in kind one for one in the renovated space. Such treatment rooms shall have no less than 80 square feet (7.43 m²) of clear floor area, the least dimension of which shall be 8 feet (2438 mm).

Equipment and supply storage shall be provided and be sized for general medical/surgical emergency supplies, medications and equipment such as ventilator, defibrillator, splints, etc. This storage shall be located in an alcove or room, out of corridor or hallway traffic, and under staff control.

Provisions for reception, control, and public waiting, including a public toilet room(s) with handwashing fixture(s), and public telephone.

Patient toilet room(s) with handwashing fixture(s) shall be immediately accessible to the treatment room(s).

Communication connections to the Poison Control Center and local EMS system shall be provided.

A patient cubicle with a minimum clear floor area of 100 square feet (9.29 m²) shall be provided under the visual control of an emergency service staff work area. The patient station shall have space at bedside for visitors and shall have provision for visual privacy from casual observation by other patients and visitors. A handwashing station shall be located in each room, and at least one handwashing station shall be provided for every four patient stations, and for each major fraction thereof, in open-bay areas. These shall be uniformly distributed to provide equal access from each patient station.

Exception: For small and rural hospitals, the observation area need not be dedicated solely for that purpose.

If provided, the airborne infection isolation exam/treatment room shall comply with the requirements of Section 1224.4.4.1.3.