Texas Register

TITLE 22 EXAMINING BOARDS
PART 5STATE BOARD OF DENTAL EXAMINERS
CHAPTER 110SEDATION AND ANESTHESIA
RULE §110.17Sedation/Anesthesia of Pediatric Patients
ISSUE 06/22/2018
ACTION Proposed
Preamble No Rule Available

(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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