Texas Register

TITLE 22 EXAMINING BOARDS
PART 5STATE BOARD OF DENTAL EXAMINERS
CHAPTER 110SEDATION AND ANESTHESIA
RULE §110.13Required Preoperative Checklist for Administration of Nitrous Oxide and Levels 1, 2, 3, and 4 Sedation/Anesthesia
ISSUE 01/18/2019
ACTION Proposed
Preamble Texas Admin Code Rule

(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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