Alabama Administrative Code › Title 540 - ALABAMA BOARD OF MEDICAL EXAMINERS › Chapter 540-X-11 - GUIDELINES FOR THE USE OF LASERS AND OTHER MODALITIES AFFECTING LIVING TISSUE › Section 540-X-11-.02 - Definitions

Current through Register Vol. 42, No. 9, June 28, 2024
For the purpose of these rules, the following definitions will
				apply:
(1) Ablative Treatment-Ablative
			 treatment shall include any laser device, any energy-based device, any
			 chemical, mechanical resection devices, or any modality that is expected or
			 intended to remove, burn, or vaporize tissue extending below the
			 dermal-epidermal junction, as well as any modality that causes coagulation
			 necrosis or pure ablation at or below the dermal-epidermal junction.
(2) Direct Physician Supervision - Direct
			 physician supervision shall mean that the physician is in the physical presence
			 of the patient being treated and is directly observing the use of the modality
			 by a delegate.
(3) Energy Source -
			 any therapeutic source which can affect or change living tissue, including
			 varying levels of ability to cause trauma and/or scarring.
(4) LLBD - Lasers and Light/Energy-Based
			 Devices - lasers/ pulsed light devices, or any energy source, chemical, or
			 other modality that affects living tissue (when referring to the skin, anything
			 below the stratum corneum), whether applied for surgical, therapeutic, or
			 cosmetic purposes.
(5) Level 1
			 Delegate -A Level 1 Delegate is an assistant to physicians (PA) as defined in
			 Ala. Code §
								34-24-290, a certified registered
			 nurse practitioner, or registered nurse (RN) authorized in a written job
			 description or protocol to use a specific laser/pulsed light device or other
			 energy source, chemical or other modality for non-ablative procedures, as
			 designated in the written job description or protocol, and who has met the
			 educational requirements for a Level 1 Delegate stated in these
			 rules.
(6) Level 2 Delegate - A
			 Level 2 Delegate is a licensed practicing nurse (LPN) or medical assistant to
			 include aestheticians, cosmetologists, and laser technicians authorized in a
			 written job description or protocol to use a specific laser/pulsed light device
			 or other energy source, chemical or other modality for non-ablative procedures,
			 as designated in the written job description or protocol, and who has met the
			 educational requirements for a Level 2 Delegate as stated in these
			 rules.
(7) Non-ablative Treatment -
			 Non-ablative treatment shall include any laser/intense pulsed light treatment
			 or other energy source, chemical or modality that, although not expected or
			 intended to remove, burn, or vaporize tissue, is intended to cause controlled
			 heat-induced thermal change/ injury to produce a result. This shall include
			 treatments related to laser hair removal and other devices defined in these
			 rules.
(8) On-Site Supervision -
			 On-site supervision shall mean continuous supervision in which the supervising
			 physician is physically present in the same building as the appropriate,
			 properly trained Legal 1 or 2 Delegate who is using an LLBD. All treatments and
			 procedures must be performed under the physician's direction and immediate
			 personal supervision, and the physician must be immediately available at all
			 times that the Level 1 or 2 Delegate is on duty. The physician retains full
			 responsibility to patients and the Board for the manner and results of all
			 services rendered.
(9) Locally
			 Remote Supervision - Locally remote supervision shall mean the geographic
			 physical proximity of a delegating physician to a Level 1 Delegate who is
			 performing a non-ablative procedure who is not providing on-site supervision
			 but who is readily available for consultation, evaluation, referral, or direct
			 medical intervention in person or by telemedicine. A locally remote physician's
			 geographic physical proximity from the patient's treatment site must not exceed
			 the usual and customary response time of emergency management services for the
			 locality. Locally remote supervision may only be provided by American Board of
			 Medical Specialties or American Osteopathic Association board-certified
			 physicians who have completed post-graduate training in lasers, light-based
			 devices, chemical peels, and any other modality that may be used to perform
			 ablative treatment.
(10) Physician
			 - A physician licensed by the Medical Licensure Commission of the State of
			 Alabama.
Author:
Alabama Board of Medical
				  Examiners
Statutory Authority:
Code of Ala.
				  1975
, §§
										34-24-50,
				  34-24-51,
				  34-24-53.