16 Del. Admin. Code § 3335-3.0

Current through Register Vol. 28, No. 3, September 1, 2024

Section 3335-3.0 - Patient Care

3.1 The physician/dentist/podiatrist must determine that the facility is an appropriate forum for the particular procedure(s) to be performed on the particular patient.

3.2 The physician/dentist/podiatrist and/or when involved, the certified registered nurse anesthetist, must determine whether the patient is an appropriate candidate for the anesthesia to be provided in the facility using the ASA classification system.

3.2.1 The physician/dentist/podiatrist or certified registered nurse anesthetist must examine the patient immediately before the procedure to evaluate the risk of anesthesia and of the procedure to be performed.

3.3 The facility must maintain written protocols for the timely and safe transfer of a patient to a hospital for emergency care or hospitalization if necessary.

3.4 At least one attending clinical team member must be certified in Advanced Cardiac Life Support.

3.5 The facility must maintain equipment and supplies, unless precluded or invalidated by the nature of the patient, procedure, or equipment, including but not limited to:

3.5.1 Age-appropriate and size-appropriate monitors, resuscitative equipment, supplies and medication in accordance with the scope of the procedures and the anesthesia services provided, including, but not limited to:

3.5.1.1 Electrocardiographic monitor;

3.5.1.2 Blood pressure monitor;

3.5.1.3 Pulse oximeter;

3.5.1.4 Continuous suction device;

3.5.1.5 Positive pressure ventilation device;

3.5.1.6 Oxygen;

3.5.1.7 Emergency intubation equipment;

3.5.1.8 IV solutions and IV tubing;

3.5.1.9 Sufficient ampoules of dantrolene sodium or similar FDA approved drug, if the facility utilizes anesthetic agents that trigger malignant hyperthermia;

3.5.1.10 Esophageal or precordial stethoscope;

3.5.1.11 Temperature monitoring device;

3.5.1.12 End tidal CO2 monitor;

3.5.1.13 Crash cart which shall include:

3.5.1.13.1 Appropriate resuscitative equipment; and

3.5.1.13.2 Medications for surgical, procedural or anesthetic complications;

3.5.2 Appropriate sterilization equipment; and

3.5.3 Adequate procedure room lighting.

3.6 Written informed consent is required prior to the procedure reflecting:

3.6.1 The patient's knowledge of the identified risks of the procedure (including anesthesia);

3.6.2 The consent to the procedure;

3.6.3 The licensed individual performing the procedure;

3.6.4 The type of anesthesia to be administered; and

3.6.5 The anesthesia provider.

3.7 The facility must maintain a policy/procedure for a time-out to ensure the risk of medical error is minimized.

3.8 A registered nurse with post-anesthesia care experience and certification in Advanced Cardiac Life Support or a physician/dentist/podiatrist/physician assistant/certified registered nurse anesthetist must monitor the patient until the patient has met the facility's criteria for discharge.

3.9 A physician/dentist/podiatrist must be available onsite during patient treatment and until the patients are medically discharged.

16 Del. Admin. Code § 3335-3.0

23 DE Reg. 125( 8/1/2019) (final)