Section 6.08 - Mobile Facility Permit D-H: Facility Requirements for Dental Offices Using Mobile and/or Portable Anesthesia ServicesEach dental facility or practice site utilizing mobile or portable anesthesia services is required to have a Facility Permit D-H. The operating dentist shall be responsible for ensuring that the qualified dental anesthesiologist has the proper individual anesthesia permit issued by the Board, and that the portable anesthesia service is appropriately permitted and equipped in accordance with 234 CMR 6.00 for the level of pain control and/or sedation to be provided.
(1)Application. An applicant shall submit an accurate and complete application on form(s) provided by the Board and accompanied by the permit fee to be determined annually by the Executive Office of Administration and Finance. The application shall, at a minimum, include the following: (a) Applicant name and Massachusetts dental license number;(b) Name(s) of dental establishment(s), owner(s) of said establishment(s), and address(es) of the site(s) where anesthesia will be administered; and(c) Documentation of the provision and maintenance of equipment, materials, and drugs and emergency response protocols required by the Board pursuant to 234 CMR 6.08(2).(2)Equipment and Drugs Required for Facility Permit D-H. Equipment and Drugs Required for Facility Permit D-H. A facility that hosts a mobile or portable dental anesthesia service will be required, at a minimum, to have the following equipment supplies and drugs:(a)Equipment and Supplies:1. Alternative light source for use during power failure;2. Automated or manual external defibrillator, except that the manual defibrillator shall only be operated by an individual certified in ACLS or PALS;3. Disposable CPR masks (pediatric and adult);4. Disposable syringes, assorted sizes;5. Latex-free tourniquet;6. Oxygen (portable Cylinder E tank) pediatric and adult masks capable of giving positive pressure ventilation (including bag-valve-mask system);7. Sphygmomanometer and stethoscope (pediatric and adult);9. Any other equipment as may be required by the Board.(b)Drugs. The following drugs and/or categories of drugs shall be provided and maintained in accordance with the AHA/ACLS Guidelines ( 234 CMR 6.02) or as determined by the Board for emergency use. All drugs shall be current and not expired 1. Acetylsalicylic acid (readily absorbable form);4. Antihypoglycemic agent;6. Epinephrine preloaded syringes (pediatric and adult);7. Two epinephrine ampules;10. Any other drugs or categories of drugs as may be required by the Board.(3) The operating dentist shall be responsible for ensuring that the qualified dental anesthesiologist has the proper anesthesia permit and that the portable anesthesia service is appropriately permitted for the level of pain control and/or sedation to be provided.