N.J. Admin. Code § 8:43A-12.2

Current through Register Vol. 56, No. 11, June 3, 2024
Section 8:43A-12.2 - Definitions

The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise;

"Advanced Cardiac Life Support" (ACLS) means that an individual has successfully completed a course of training offered by an individual who is currently certified as an instructor by the American Heart Association or by a recognized accrediting organization appropriate to the licensee's field of practice. For example, for those treating adult patients, training in ACLS is appropriate and for those treating children, training in pediatric advanced life support (PALS) is appropriate.

"Analgesia" means the absence of the sensibility to pain without loss of consciousness or decrease in the intensity of pain.

"Anesthesia" consists of general anesthesia and spinal or regional anesthesia. It does not include local anesthesia.

"Anesthesiologist" means a physician who has successfully completed an approved residency program in anesthesiology, or who is a diplomate of either the American Board of Anesthesiology or the American Osteopathic Board of Anesthesiology, or who was made a Fellow of the American College of Anesthesiology before 1982.

"Anesthetic agent" means any drug or combination of drugs administered with the purpose of creating conscious sedation, deep sedation, regional anesthesia, or general anesthesia.

"Anesthetizing location" means any location in a health care facility where anesthetic agents are administered.

"Certified registered nurse anesthetist" (CRNA) means a registered professional nurse who is licensed by the New Jersey State Board of Nursing and who holds current certification under a program governed or approved by the American Association of Nurse Anesthetists (AANA), and who meets the conditions for practice as set forth at N.J.A.C. 13:37-13.1.

"Conscious sedation" means a drug induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain an open airway, and spontaneous ventilation is adequate. Adequate cardiovascular function is usually maintained. Within the context of this subchapter, "conscious sedation" shall be synonymous with the term "sedation/analgesia" as used by the American Society of Anesthesiologists.

"Deep sedation" means a drug induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.

"Epidural" means an anesthetic injected into the epidural space surrounding the fluid filled sac (the dura) around the spine which partially numbs the abdomen and legs.

"General anesthesia" means a drug induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patient airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug induced depression of neuromuscular function. Cardiovascular function may be impaired.

"Labor analgesia" means the reduction or management of pain during labor, which involves the use of anesthetic agents and/or an epidural.

"Local anesthesia" consists of drugs or agents which produce a transient and reversible loss of sensation in a circumscribed portion of the body.

"Major regional anesthesia" means nerve blocks such as epidural, caudal, axillary, brachial, and spinal anesthesia.

"Minor regional block" means the injection of a local anesthetic to stop a painful sensation in a severely circumscribed area of the body (local infiltration or local nerve block), or the block of a nerve by direct pressure and refrigeration.

"Minor surgery" means surgery which can safely and comfortably be performed on a patient who has received no more than the maximum manufacturer recommended dose of local or topical anesthesia, without more than minimal pre-operative medication or minimal intraoperative tranquilization and where the likelihood of complications requiring hospitalization is remote. Minor surgery specifically excludes all procedures performed utilizing anesthesia services as defined in this section. Minor surgery also specifically excludes procedures which may be performed under local anesthesia, but which involve intensive manipulation or removal of tissue such as liposuction or lipo-injection, breast augmentation or reduction, and removal of breast implants. Minor surgery includes the excision of moles, warts, cysts, lipomas, skin biopsies, the repair of simple lacerations, or other surgery limited to the skin and tissue. Additional examples of minor surgery include closed reduction of a fracture, the incision and drainage of abscesses, certain simple ophthalmologic surgical procedures, such as treatment of chalazions and non-invasive ophthalmologic laser procedures performed with topical anesthesia, limited endoscopies , such as , flexible sigmoidoscopies, anoscopies, proctoscopies, arthrocenteses, thoracenteses , and paracenteses. Minor surgery shall not include any procedure identified as "major surgery" within the meaning at N.J.A.C. 13:35-4.1.

"Monitoring" means the observation of a patient including the use of instruments to measure, display, and/or record (continuously or intermittently) the values of certain physiologic variables such as temperature, pulse, respiration, blood pressure, and oxygen saturation.

"Operating room" means a unit for the performance of surgery.

"Pain management" means the administration of drugs to a patient, which are not intended to result in a loss of consciousness, awareness or defensive reflexes, but which are intended to alleviate pain occurring in the absence of an invasive, operative, or manipulative procedure.

"Practitioner" means a licensed physician, dentist or podiatrist.

"Privileges" means having been granted permission by a facility to provide specified anesthesia services, such as the administration or supervision of one or more types of anesthetic agents or procedures.

"Regional anesthesia" means the administration of anesthetic agents to interrupt nerve impulses.

"Registered nurse anesthetist" means an individual who is a qualified candidate for certification under a program governed or approved by the American Association of Nurse Anesthetists (AANA), subject to the limitations and restrictions established by the New Jersey State Board of Nursing (N.J.A.C. 13:37-13.2, Practice pending the results of the examination).

"Special procedure" means various diagnostic or therapeutic interventions which may require the administration of sedation, analgesia, or anesthesia. Examples include, but are not limited to: endoscopy, oral surgery, radiologic procedures or emergency procedures.

"Special procedure room" means the appropriately equipped facility location in which special procedures are performed.

"Supervision" means responsibility by a physician who has obtained facility privileges in accordance with medical staff bylaws, and is immediately available on-site overseeing the administration and monitoring of anesthesia.

Immediately available on-site means that the supervising physician is present and is available to respond and proceed immediately to the anesthetizing location.

"Universal precautions" means a set of precautions, in accordance with Centers for Disease Control and Prevention published guideline for Handwashing and Hospital Environmental Control. (Centers for Disease Control and Prevention Guideline for Prevention of Surgical Site Infections (1999) (Infection Control and Hospital Epidemiology 1999; 20:247-278), incorporated herein by reference, as amended and supplemented. That publication may be obtained by telephoning the Centers for Disease Control and Prevention at (800) 311-3435.)

N.J. Admin. Code § 8:43A-12.2

Amended by R.2003 d.56, effective 2/3/2003.
See: 34 New Jersey Register 224(a), 35 New Jersey Register 857(a).
Rewrote the section.
Notice of readoption with technical change, effective 1/3/2022.
See: 54 N.J.R. 60(a).