D.C. Mun. Regs. tit. 17, r. 17-10799

Current through Register Vol. 71, No. 43, October 25, 2024
Rule 17-10799 - DEFINITIONS
10799.1

As used in this chapter, the following terms have the meaning ascribed:

Advanced Cardiac Life Support (ACLS) - a certification that an individual has successfully completed an advanced cardiac life support course that includes hands on training and skills demonstration of airway management and automated external defibrillator (AED) use offered by the American Heart Association or other entity approved by the Board.

Anesthesia -an artificially induced insensibility to pain usually achieved by the administration of gases or the use of drugs.

Anesthesia and sedation-

(a) Moderate sedation;
(b) Deep sedation; and
(c) General anesthesia.

Anxiolysis- the oral administration in a single dose of one type of legally prescribed sedative, narcotic, class of drug, or medication to decrease anxiety taken the evening before a procedure or the day of a procedure or both. Anxiolysis is used to achieve a drug induced state in which patients are expected to appropriately respond to tactile stimulation and verbal function and coordination may be impaired. Ventilatory and cardiovascular functions are maintained and require no assistance.

Deep sedation- is an induced state of depressed consciousness accompanied by partial loss of protective reflexes, including the inability to continually maintain an airway independently or to respond purposefully to physical stimulation or verbal command, and is produced by a pharmacologic or non-pharmacologic method or a combination thereof. Airway intervention may be needed. Spontaneous ventilation may be inadequate and cardiovascular function is usually maintained. Patients cannot be easily aroused but respond purposefully following repeated or painful stimulation.

Director - the Director of the Department of Health, or designee.

Facility- any location in which anesthesia or sedation is administered for the practice of dentistry, including a dental school recognized by the Commission on Dental Accreditation or its successor organization or a hospital that is not in good standing with the District or the Joint Commission, but does not include a van or any mobile or temporary structure.

General Anesthesia - an induced state of consciousness, accompanied by partial or complete loss of protective reflexes, including the inability to continually maintain an airway independently and respond purposefully to physical stimulation or verbal command, and is produced by a pharmacologic or non-pharmacologic method or a combination thereof. Patients are not arousable even by painful stimulation. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation, drug-induced depression, or changes in neuromuscular function. Cardiovascular function may be impaired.

Itinerant Provider- a licensed physician, certified registered nurse anesthetist, or dentist that administers anesthesia and sedation to a treating dentist's patients at the treating dentist's practice location or by traveling from practice site to practice site.

Local Anesthesia- the technique of reducing or eliminating the body's response to noxiousstimuli by the regional injection or application of a drug to a specific area of the body that inhibits nerve excitation or conduction without affecting or altering consciousness.

Moderate Sedation- a minimally depressed level of consciousness that retains the patient's ability to independently and continuously maintain an airway and respond appropriately to physical stimulation and verbal command and that is produced by a pharmacologic or non-pharmacologic method or airway, and spontaneous ventilation is adequate. Cardiovascular function is maintained. Patients whose only response is reflex withdrawal from repeated painful stimuli shall not be considered to be in a state of conscious sedation.

Nitrous Oxide and Oxygen- an inhalation combination used to reduce pain and anxiety which could also depress the level of consciousness. The quantity of Nitrous Oxide administered shall not produce levels of altered consciousness beyond that which has been defined in this chapter as anxiolysis.

On-site Physical Facility Evaluation- an on-site inspection to determine if a facility where the applicant proposes to provide anesthesia and sedation is adequately supplied, equipped, staffed, and maintained in a condition to support the provision of anesthesia and sedation services in a manner that meets the requirements of this chapter.

Pediatric Advanced Life Support (PALS) certification - a certification that an individual has successfully completed a pediatric advanced cardiac life support course that includes hands on training and skills demonstration of airway management and automated external defibrillator (AED) use offered by the American Heart Association or other entity approved by the Board.

Provisional Certification- a one-year certification issued to an applicant for a dental certification, a dental facility certification, or to an itinerant dental provider applicant at the time that the application is received by the Department, that substantially meets the requirements for a certification, and can reasonably be expected to meet the outstanding requirements within a year.

Renewal Evaluation- an on-site inspection by the Board or its designee before the renewal of a certification to determine if a facility where the applicant proposes to provide anesthesia and sedation is adequately supplied, equipped, staffed, and maintained in a condition to support the provision of anesthesia and sedation services in a manner that meets the requirements of this chapter.

Sedation- any altered or decreased state of consciousness beyond that which is defined in this chapter as anxiolysis, regardless of the method or route of administration of the drug, medication or inhalation agent. The levels of sedation are (a) Moderate Sedation, (b) Deep Sedation, and (c) General Anesthesia.

Treating Dentist- the dentist who will perform the dental treatment, procedures, or services for which the administration of anesthesia or sedation to the patient is required.

10799.2

The definitions in § 4099 of Chapter 40 of this title are incorporated by reference into and are applicable to this chapter.

D.C. Mun. Regs. tit. 17, r. 17-10799

Final Rulemaking published at 67 DCR 7779 (6/19/2020); amended by Final Rulemaking published at 67 DCR 8806 (7/17/2020)