(a)For purposes of this rule, the following definitions
apply:
(1)"Pediatric patient" means a patient younger than
13 years of age.
(2)"Board-approved education program" means an in-person
or online program provided by a recognized continuing education provider
pursuant to Board rule 22 Tex. Admin. Code §104.2 and any subsequent
amendments.
(b)On or after September 1, 2019, a permit holder
may not administer sedation/anesthesia under a level 2, level 3, or
level 4 permit to a pediatric patient unless the permit holder has
completed the requirements of paragraphs (1) or (2) of this subsection.
Permit holders must have:
(1)completed a university or hospital-based residency
at least 12 months in length. All permit holders completing a university
or hospital-based residency after September 1, 2019, must confirm
that during the residency, the permit holder completed satisfactory
management of sedation/anesthesia in at least fifteen (15) cases involving
pediatric patients sedated/anesthetized at the highest level of permit
held. The cases must include at least three (3) live cases in which
the permit holder is the primary sedation/anesthesia provider, no
more than seven (7) cases observed on live patients, and no more than
five (5) cases performed as part of a hands-on high-fidelity sedation
simulation center or program; or
(2)completed a board-approved education program that
includes a minimum of sixteen (16) hours of didactic training and
instruction in sedation/anesthesia of pediatric patients. The entire
board-approved education program, including all didactic and clinical
requirements, must be completed within a two-year period of beginning
the Board-approved program. Successful completion of the program must
include passing an evaluation to demonstrate satisfactory completion
of the course requirements. Didactic education must include:
(A)pre-anesthetic patient assessment/evaluation for
medically compromised and geriatric patients;
(B)physical evaluation and medical history of pediatric
patients, including obesity, limited neck mobility, micro/retrognathia,
macroglossia, Mallampati score, and limited oral opening;
(C)pediatric anatomical and/or physiological differences;
(D)pediatric respiratory assessment, including airway
anatomy, physiology, and management;
(E)informed consent by parent, guardian, or care-giver;
(F)sedation/anesthesia pharmacology;
(G)sedation/anesthesia management of pediatric patients;
(H)pediatric patient monitoring;
(I)peri-operative complications and emergencies;
(J)emergency management of pediatric patients, including
pediatric anesthesia equipment and resuscitation supplies;
(K)sedation/anesthesia technique;
(L)sedation/anesthesia record keeping;
(M)patient recovery and discharge;
(N)pediatric case selection and reference behavior
scale; and
(O)permit holders shall have completed satisfactory
management of sedation/anesthesia in at least fifteen (15) cases involving
pediatric patients sedated/anesthetized at the highest level of permit
held. The cases must include at least three (3) live cases in which
the permit holder is the primary sedation/anesthesia provider, no
more than seven (7) cases observed on live patients, and no more than
five (5) cases performed as part of a hands-on high-fidelity sedation
simulation center or program. All of the cases must be performed and
documented under the on-site instruction and direct supervision of
a licensed dentist authorized to administer sedation/anesthesia to
pediatric patients.
(c)A permit holder is authorized to administer sedation/anesthesia
under a level 2, level 3, or level 4 permit to a pediatric patient
if they have completed the requirements above and have requested and
received authorization from the Board to administer sedation/anesthesia
to pediatric patients. Board staff shall promulgate appropriate forms
for permit holders qualifying under subsection (b)(1) and (b)(2) of
this section. The permit holder must attest to their advanced training
satisfying the requirements of subsection (b)(1) or (b)(2) of this
section, and will be required to produce proof of completion as part
of a permit inspection or an investigation of a complaint involving
sedation/anesthesia of a pediatric patient.
(d)The education hours described in subsection (b)(2)
of this section can be applied towards the permit holder's continuing
education requirement for maintaining a sedation/anesthesia permit.
(e)If qualifying under subsection (b)(2) of this section,
the didactic and clinical training described in subsection (b)(2)
of this section may not be fulfilled by the same didactic and clinical
training used to fulfill the requirements for initial sedation/anesthesia
permit issuance.
The agency certifies that legal counsel
has reviewed the proposal and found it to be within the state agency's
legal authority to adopt.
Filed with the Office
of the Secretary of State on June 8, 2018
TRD-201802560 W. Boyd Bush, Jr.
Executive Director
State Board of Dental Examiners
Earliest possible date of adoption: July 22, 2018
For further information, please call: (512) 475-0987
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