Basic Pediatric Receiving Center

(§100160.02)

• Licensed with a basic or standby emergency department permit
• Physician staffing or a physician available for consultation 24/7/365
• At least one RN or advanced practice practitioner per ED shift with current PALS, APLS, ENPC, or LEMSA-approved equivalent
• ED able to stabilize critically ill or injured infants, children, and adolescents prior to admission or transfer
• One PECC (physician, nurse, NP, or PA) — may be shared with other PedRCs
• Agreements with at least one comprehensive PedRC for staff education, consultation, and transfer of critical pediatric patients
• Agreements with an advanced or general PedRC for consultation and transfer
• Transfer agreements for specialized care not otherwise available (trauma, burn, spinal cord injury, rehabilitation, behavioral health)
• Additional requirements may be added by the LEMSA Medical Director

General Pediatric Receiving Center

(§100160.03)

• Licensed with a basic or comprehensive emergency department permit
• ED able to stabilize critically ill or injured infants, children, and adolescents prior to admission or transfer
• Neonatal resuscitation equipment: pediatric laryngoscope with Miller 0 and 00 blades, 2.5 and 3.0 endotracheal tubes, umbilical vein catheters
• Two PECCs — one physician plus one nurse, NP, or PA; may be shared with other PedRCs
• Participate with a comprehensive and/or advanced PedRC for pediatric emergency education, consistent with the LEMSA education plan
• Agreements with comprehensive and/or advanced PedRCs for education, consultation, and transfer
• Transfer agreements for specialized care not otherwise available
• Additional requirements may be added by the LEMSA Medical Director

Advanced Pediatric Receiving Center

(§100160.04)

CDPH licensing (Title 22, Div. 5, Ch. 1)

• As a GACH (§§ 70003, 70005)
• For pediatric service (§ 70535 et seq.)
• For basic or comprehensive emergency department (§§ 70411, 70451 et seq.)
• For social services (§ 70629 et seq.)
• As a Community or Intermediate NICU, if applicable (perinatal services § 70545 et seq.; ICNN § 70481 et seq.)
• If a PICU is operated, licensed for intensive care services (§ 70491 et seq.)

Capabilities and equipment

• ED able to stabilize critically ill or injured pediatric patients prior to PICU admission or transfer to a comprehensive PedRC
• All general PedRC equipment, plus standardized pediatric crash carts on every unit where pediatric patients receive care (ED, radiology suite, inpatient pediatrics)

In-house services, 24/7/365

• Respiratory care in the pediatric service and ED by CA-licensed RCPs with formal pediatric respiratory training and clinical pediatric experience
• Social work by an MSW with expertise in psychosocial issues affecting families of seriously ill children
• Behavioral health specialists with pediatric experience (psychiatrists, psychologists, nurses)

On-call consultation tiers

• Within 30 minutes by phone, on-site within 60 minutes when clinically necessary: neonatologist; general surgeon with pediatric experience; anesthesiologist or nurse anesthetist with pediatric experience
• Within 30 minutes in person, by phone, or by telehealth: radiologist, otolaryngologist, mental health professional, and orthopedist (each with pediatric experience); pediatric cardiologist
• Available 24/7/365 for consultation — may be met via transfer agreement or telehealth: pediatric gastroenterology, hematology/oncology, infectious disease, nephrology, neurology, surgery, and endocrinology; cardiac surgeon, neurosurgeon, OB/GYN, and pulmonologist with pediatric experience

Agreements, education, staffing

• Agreement with at least one comprehensive PedRC for consultation
• Transfer agreement with a comprehensive PedRC for stabilization and highest level of care
• Transfer agreements for specialized care not otherwise available
• Participate with a comprehensive PedRC for pediatric emergency education
• Physician and nurse PECC (note: not shareable at this level)
• Additional requirements may be added by the LEMSA Medical Director

Comprehensive Pediatric Receiving Center

(§ 100160.05)

Must meet every Advanced PedRC requirement, plus:

• Approved by DHCS as a California Children's Services (CCS) tertiary hospital
• Able to provide comprehensive specialized pediatric medical and surgical care to any acutely ill or injured child
• A separate pediatric ED, or a designated pediatric area within the ED, staffed by physicians who are qualified specialists in emergency medicine or pediatric emergency medicine
• Inpatient resources including both a NICU and a PICU
• Provide ongoing outreach and pediatric education to the community, general and basic PedRCs, and prehospital providers, in collaboration with the LEMSA
• Establish transfer agreements or serve as the regional referral center for specialized care (trauma, burn, spinal cord injury, rehabilitation, behavioral health)
• Additional requirements may be added by the LEMSA Medical Director