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

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

### Chapter 14 — Hand and Upper Extremity Trauma Center Standards

#### Regulation .03 Medical Staff.

*COMAR 30.08.14.03*

A. The hospital shall have a hand and upper extremity physician trauma team that shall include at least eight physicians who are Board-eligible or Board-certified in the following specialties:

  (1) General surgery;

  (2) Plastic surgery; or

  (3) Orthopedic surgery.

B. A member of the hand and upper extremity physician trauma team shall be on call 24 hours a day with a response time of 30 minutes or less.

C. As back-up, a second member of the hand and upper extremity physician trauma team shall be on call 24 hours a day with a response time of 30 minutes or less.

D. The physicians who satisfy §A of this regulation shall also hold or be eligible to hold a Certificate of Added Qualifications in Hand Surgery through:

  (1) The American Board of Orthopedic Surgery;

  (2) The American Board of Plastic Surgery; or

  (3) The American Board of Surgery.

E. Each member of the hand and upper extremity trauma physician trauma team shall be competent in:

  (1) Microsurgery of the upper extremity;

  (2) Neurovascular surgery of the upper extremity;

  (3) Emergency skeletal reconstruction;

  (4) Emergency soft tissue reconstruction; and

  (5) Upper limb replantation.

F. A call roster for the hand and upper extremity physician trauma team shall be published and available in the emergency department and operating room.