Md. Code Regs. 10.44.12.08

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.44.12.08 - Qualifications for Obtaining a Permit

A. Because sedation is a continuum, it is not always possible to predict how an individual patient will respond. Therefore, practitioners intending to produce a given level of sedation shall be able to recover patients whose level of sedation becomes deeper than initially intended. Individuals administering moderate enteral sedation or moderate parenteral sedation shall be able to recover patients who enter a state of deep sedation or general anesthesia, while those administering deep sedation shall be able to recover patients who enter a state of general anesthesia. Training and evaluation guidelines shall reflect this concern.

B. In addition to the requirements outlined in this regulation, in order to obtain a permit, a dentist shall also meet the requirements outlined in Regulations .09-.11 of this chapter.

C. A permit may be issued to a dentist authorizing the use of moderate sedation, deep sedation, or general anesthesia at a specific practice location.

D. Class I: Moderate Enteral Sedation Permit. To qualify for a Class I permit, an applicant shall successfully complete:

(1) A Board-approved course of instruction that documents training of at least 24 hours of didactic education plus 20 clinically oriented experiences that provide competency in oral and combination inhalation-oral moderate sedation; or

(2) A postdoctoral training program accredited by the Commission on Dental Accreditation or its successor organization that affords comprehensive and appropriate training necessary to administer and manage moderate enteral sedation.

E. Clinically oriented experiences referred to in §D(1) of this regulation may include:

(1) Supervised administration;

(2) Observations of videotaped patients undergoing oral or combination inhalation-oral moderate sedation; or

(3) Human simulation.

F. In addition to the requirements outlined in §D of this regulation, an applicant for a Class I permit shall:

(1) Hold current certification in either ACLS or PALS, which the permit holder may not allow to expire, or successfully complete a course approved by the Board that provides instruction on medical emergencies and airway management;

(2) Receive a successful evaluation by the Board or the Board's designee;

(3) Provide an affidavit to the Board indicating whether the applicant has ever treated a patient under deep sedation or general anesthesia with an incident; and

(4) Submit any other pertinent documents or information requested by the Board.

G. An affidavit provided to the Board under §F(3) of this regulation, which indicates that the applicant has treated a patient under deep sedation or general anesthesia with an incident, shall include at least the following:

(1) The date of the incident;

(2) The name, age, and address of the patient;

(3) The patient's original complete dental records;

(4) The name and license number of the licensee and the name and address of all other persons present during the incident;

(5) The address where the incident took place;

(6) The preoperative physical condition of the patient;

(7) The type of anesthesia and dosages of drugs administered to the patient;

(8) The techniques used in administering the drugs;

(9) Any adverse occurrence including:

(a) The patient's signs and symptoms;

(b) The treatments instituted in response to adverse occurrences;

(c) The patient's response to the treatment; and

(d) The patient's condition on termination of any procedures undertaken; and

(10) A narrative description of the incident including approximate times and evolution of symptoms.

H. lass II: Moderate Parenteral Sedation Permit. To qualify for a Class II permit, an applicant shall successfully complete:

(1) A Board-approved course of instruction that documents training of at least 60 hours of didactic instruction plus management of at least 20 dental patients, who may be simulated, per participant in moderate parenteral sedation techniques; or

I. In addition to the requirements outlined in §§H and I of this regulation, an applicant for a Class II permit shall:

(1) Hold current certification in either ACLS or PALS, which the permit holder may not allow to expire;

(2) Receive a successful evaluation by the Board or the Board's designee;

(3) Provide an affidavit to the Board indicating whether the applicant has ever treated a patient under deep sedation or general anesthesia with an incident; and

(4) Submit any other pertinent documents or information requested by the Board.

J. An affidavit provided to the Board under §I(3) of this regulation, which indicates that the applicant has treated a patient under deep sedation or general anesthesia with an incident, shall include the information contained in §G of this regulation.

K. Class III: Deep Sedation and General Anesthesia Permit. To qualify for a Class III permit, an applicant shall have successfully completed:

(1) An advanced training program in anesthesia and related subjects beyond the undergraduate dental curriculum that is approved by the Board; or

L. In addition to the requirements outlined in §I of this regulation, an applicant for a Class III permit shall:

(1) Hold current certification in either ACLS or PALS, which the permit holder may not allow to expire;

(2) Receive a successful evaluation by the Board or its designee;

(3) Provide an affidavit to the Board indicating whether the applicant has ever treated a patient under deep sedation or general anesthesia with an incident; and

(4) Submit any other pertinent documents or information requested by the Board.

M. An affidavit provided to the Board under §L(3) of this regulation, which indicates that the applicant has treated a patient under deep sedation or general anesthesia with an incident, shall include the information contained in §G of this regulation.

Md. Code Regs. 10.44.12.08

Regulations .08 under General Anesthesia, repealed, and new Regulations .08 under Anesthasia and Sedation, adopted effective January 4, 2010 (36:18 Md. R. 1380)
Regulation .08 amended effective 42:9 Md. R. 648, eff.5/11/2015