# COMAR Title 30 — Maryland Institute for Emergency Medical Services Systems (MIEMSS)

## Subtitle 08 — Designation of Trauma and Specialty Referral Centers

### Chapter 08 — Pediatric Trauma Center Standards

#### Regulation .08 Pediatric Intensive Care Unit (PICU).

*COMAR 30.08.08.08*

A. The hospital shall have a separate PICU with the capability to care for all significantly injured children.

B. The PICU shall:

  (1) Have appropriately trained registered nurse staff to care for the critically injured child to include:

    (a) Brain injury;

    (b) Spinal cord injury;

    (c) Solid organ injury;

    (d) Chest injury;

    (e) Complex musculoskeletal injury;

    (f) Burns;

    (g) Eye injury;

    (h) Hand and upper extremity injury; and

    (i) Lower extremity injury;

  (2) Be staffed at a level to ensure appropriate nurse-patient ratios as determined by written nursing standards;

  (3) Have a written plan to:

    (a) Triage children from the PICU to accommodate acute admissions; or

    (b) Provide alternative critical care beds with appropriately trained pediatric critical care registered nurses;

  (4) Have available the pediatric resuscitation equipment and medications;

  (5) Have the equipment and capability for continuous invasive monitoring of the critically injured child;

  (6) Have extracorporeal membrane oxygenation capability;

  (7) Have capability for all renal replacement therapies; and

  (8) Have support services with immediate access to clinical diagnostic services and stat lab.