190.243. Transportation to trauma, STEMI, or stroke centers or hospitals, how authorized.

MISSOURI STATUTES AND CODES

190.243. Transportation to trauma, STEMI, or stroke centers or hospitals, how authorized.

Transportation to trauma, STEMI, or stroke centers or hospitals, howauthorized.

190.243. 1. Severely injured patients shall be transported to atrauma center. Patients who suffer a STEMI, as defined in section 190.100,shall be transported to a STEMI center. Patients who suffer a stroke, asdefined in section 190.100, shall be transported to a stroke center.

2. A physician or registered nurse authorized by a physician who hasestablished verbal communication with ambulance personnel shall instructthe ambulance personnel to transport a severely ill or injured patient tothe closest hospital or designated trauma, STEMI, or stroke center, asdetermined according to estimated transport time whether by groundambulance or air ambulance, in accordance with transport protocol approvedby the medical director and the department of health and senior services,even when the hospital is located outside of the ambulance service'sprimary service area. When initial transport from the scene of illness orinjury to a trauma, STEMI, or stroke center would be prolonged, the STEMI,stroke, or severely injured patient may be transported to the nearestappropriate facility for stabilization prior to transport to a trauma,STEMI, or stroke center.

3. Transport of the STEMI, stroke, or severely injured patient shallbe governed by principles of timely and medically appropriate care;consideration of reimbursement mechanisms shall not supersede thoseprinciples.

4. Patients who do not meet the criteria for direct transport to atrauma, STEMI, or stroke center shall be transported to and cared for atthe hospital of their choice so long as such ambulance service is not inviolation of local protocols.