|(a) Pursuant to Texas Occupations Code §258.1557,
all permit holders, including nitrous oxide/oxygen inhalation sedation
permit holders, must develop written emergency preparedness policies
and procedures specific to the permit holder's practice setting that
establish a plan for the management of medical emergencies in each
practice setting in which the dentist administers sedation/anesthesia.
(b) The emergency preparedness policies and procedures
must include written protocols, policies, procedures, and training
requirements specific to the permit holder's equipment and drugs for
responding to emergency situations involving sedation/anesthesia,
including information specific to respiratory emergencies.
(c) The permit holder must annually review the emergency
preparedness policies and procedures to determine whether an update
is necessary. The permit holder must maintain documentation of the
dates of the emergency preparedness policies and procedures' creation,
the most recent update, and the most recent annual review.
(d) Policies and procedures developed by all permit
holders must include basic life support protocols, advanced cardiac
life support rescue protocols, and/or pediatric advanced cardiac life
support rescue protocols if treating pediatric patients, consistent
with the requirements of §§110.3 - 110.6 of this chapter
(relating to Sedation and Anesthesia), as applied to the permit holder.
(e) Policies and procedures developed by all permit
holders must include, at a minimum, the following documents:
(1) Specific protocols for response to a sedation/anesthesia
emergency, including specific protocols for advanced airway management
(2) Staff training log, documenting staff training
in emergency prevention, recognition, and response on at least an
(3) Emergency drug log documenting annual reviews for
assurance of unexpired supply;
(4) Equipment readiness log indicating annual reviews
for assurance of function of the equipment required by §110.15
of this chapter (relating to Prevention of and Response to Sedation/Anesthesia
(5) Individual office staff roles and responsibilities
in response to an emergency, including roles and responsibilities
specific to a response to a respiratory emergency.
(f) All policies and procedures described in subsections
(c), (d), and (e) of this section must be reviewed and updated at
least annually, and must be reviewed and updated as soon as possible
after the permit holder obtains a higher permit level. Permit holders
must maintain versions of the policies and procedures described in
subsections (c), (d), and (e) of this section for at least two years
after the creation or update of the policies and procedures.