Ala. Admin. Code r. 540-X-10-.08

Current through Register Vol. 43, No. 1, October 31, 2024

Section 540-X-10-.08 - Standards For Office-Based Procedures - General And Regional Anesthesia

(1) Physician Registration Requirement: The Alabama Board of Medical Examiners requires each physician who offers office-based surgery that requires moderate sedation, deep sedation or general anesthesia, as defined in these rules to register with the State Board of Medical Examiners as an office-based surgery physician.9

(2) Equipment and supplies: Emergency resuscitation equipment, suction and a reliable source of oxygen with a backup tank must be readily available. When triggering agents are in the office, at least 12 ampules of dantrolene sodium must be readily available within 10 minutes with additional ampules available from another source. Monitoring equipment should include: blood pressure apparatus, stethoscope, pulse oximetry, continuous EKG, capnography, and temperature monitoring for procedures lasting longer than thirty (30) minutes. Monitoring equipment and supplies should be in compliance with currently adopted ASA standards 10. Facility, in terms of general preparation, must have adequate equipment and supplies, provisions for proper record keeping, and the ability to recover patients after anesthesia.

(3) Training required: The physician must be able to document satisfactory completion of training such as being Board certified or being an active candidate for certification by a Board approved by the American Board of Medical Specialties or comparable formal training. Alternative credentialing for procedures outside the physician's core curriculum must be applied for through the Alabama Board of Medical Examiners and must be approved by the Board. The physician and at least one assistant must be currently trained in Advanced Cardiac Life Support (ACLS).

(4) Assistance of other personnel: Anesthesia should be administered only by licensed, qualified and competent practitioners. Practitioners must have documented competence and training to administer general and regional anesthesia and to assist in any support or resuscitation measures as required. The individual administering general and regional anesthesia and/or monitoring the patient cannot assist the physician in performing the surgical procedure. Scrub or Circulating nurse(s) and/or assistant(s) must be trained in their specific job skills as determined by the supervising physician. Direction of the sedation/analgesia component of the medical procedure should be provided by a physician who is immediately and physically present, who is licensed to practice medicine in the state of Alabama, and who is responsible for the direction of administration of the anesthetic. The physician providing direction should assure that an appropriate pre-anesthetic examination is performed, assure that qualified practitioners participate, be available for diagnosis treatment and management of anesthesia related complications or emergencies, and assure the provision of indicated post anesthesia care. At least one physician currently trained in ACLS must be immediately and physically available until the last patient is past the first stage of recovery. At least one practitioner currently trained in ACLS must be immediately and physically available until the last patient is discharged from the facility 11.

Authors: Alabama Board of Medical Examiners ad hoc Committee: Arthur F. Toole, III, M.D.; Jorge A. Alsip, M.D.; James G. Chambers, III, M.D.; Craig H. Christopher, M.D.; Alcus Ray Hudson, M.D.; Pamela D. Varner, M.D.; James E. West, M.D.; and Task Force Sub-Committee: Jeff Plagenhoef, M.D.; Eric Crum, M.D.; Dan J. Coyle, Jr., M.D.; Gary Monheit, M.D.; Robert Hurlbutt, IV, M.D.; C. Paul Perry, M.D.; W. Guinn Paulk, M.D.; Mark McIlwain, D.M.D., M.D.; Jerald Clanton, D.M.D., M.D.; Patrick J. Budny, M.D.; James W. Northington, M.D.; David Franco, M.D.; Thomas E. Moody, M.D.

Ala. Admin. Code r. 540-X-10-.08

New Rule: Filed October 17, 2003; effective November 21, 2003.

Statutory Authority:Code of Ala. 1975, § 34-24-53.