(a)A dentist administering nitrous oxide or Level
1, 2, 3, or 4 sedation/anesthesia must create, [and]
maintain, and include in the patient's dental records required
by rule 108.8[,] a document titled "preoperative sedation/anesthesia
checklist." The checklist must be [" that is]
completed [by the dentist] prior to commencing a procedure
for which the dentist will administer nitrous oxide or Level 1, 2,
3, or 4 sedation/anesthesia. The checklist may be paper or electronic.
(b)A dentist delegating the administration of sedation/anesthesia
to another provider in accordance with Section 258.001(4) of the Act,
must maintain in the patient's dental records required by rule 108.8,
a document titled "preoperative sedation/anesthesia checklist."
The checklist must be [" that is] completed by the
sedation/anesthesia provider, or by the dentist delegating the
procedure with information provided by the sedation/anesthesia provider
as necessary, prior to commencing a procedure for which the
dentist has delegated another provider to administer the sedation/anesthesia.
The checklist may be paper or electronic.
(c)At a minimum, the preoperative checklist must include
documentation of the following as applicable for each level
of sedation/anesthesia administered, consistent with the requirements
of rules 110.3, 110.4, 110.5, and 110.6:
(1)Medical history, including documentation of the
following:
(A)review of patient medical history;
(B)review of patient allergies;
(C)review of patient surgical and/or anesthesia history;
(D)review of family surgical and/or anesthesia history;
and
(E)review of patient medications and any modifications
;[.]
(2)Confirmation that written and verbal preoperative
and post-operative instructions were delivered to the patient, parent,
legal guardian, or care-giver;
(3)Medical consults, as needed;
(4)Physical examination, including documentation of
the following:
(A)American Society of Anesthesiologists Physical
Status Classification (ASA) classification;
(B)NPO status; and
(C)Preoperative vitals, including height, weight,
blood pressure, pulse rate, and respiration rate;
(5)Anesthesia-specific physical examination including
documentation of the following as necessary for the level of
sedation/anesthesia administered:
(A)Airway assessment, including Mallampati score and/or
Brodsky score as necessary for adequate patient evaluation;
and
(B)Ventilation and respiratory rate obtained
through patient observation, auscultation, or capnography [Auscultation
];
(6)Confirmation of pre-procedure equipment readiness
check;
(7)Confirmation of pre-procedure treatment review
(correct patient and procedure); and
(8)Special preoperative considerations as indicated
for sedation/anesthesia administered to pediatric or high risk patients
.[; and]
(d)[(9)] The preoperative
checklist must include documentation [Documentation]
of the reason for omission of any items [item]
required by subsection (c) of this section.
(e)[(d)] The information required
in subsection (c) of this section [above] may be
gathered at any time, but the dentist administering or delegating the
administration of sedation/anesthesia must verify that the information
is current and correct prior to the administration of sedation/anesthesia.
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 January 4, 2019
TRD-201900023 W. Boyd Bush, Jr.
Executive Director
State Board of Dental Examiners
Earliest possible date of adoption: February 17, 2019
For further information, please call: (512) 305-9332
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