Alabama Administrative Code › Title 540 - ALABAMA BOARD OF MEDICAL EXAMINERS › Chapter 540-X-10 - OFFICE-BASED SURGERY › Section 540-X-10-.06 - Standards For Office-Based Procedures - Moderate Sedation/Analgesia

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Physician
			 Registration Requirement: The Alabama Board of Medical Examiners requires each
			 physician who offers office-based surgery that requires moderate sedation, deep
			 sedation or general anesthesia, as defined in these rules to register with the
			 State Board of Medical Examiners as an office-based surgery
			 physician.7
(2) Equipment and
			 supplies: Emergency resuscitation equipment, emergency life-saving medications,
			 suction, and a reliable source of oxygen with a backup tank must be readily
			 available. When medication for sedation and/or analgesia is administered
			 intravenously (IV), monitoring equipment should include: blood pressure
			 apparatus, stethoscope, pulse oximetry, continuous EKG, and temperature
			 monitoring for procedures lasting longer than thirty (30) minutes. Patient's
			 vital signs, oxygen saturation, and level of consciousness should be documented
			 prior to the procedure, during regular intervals throughout the procedure, and
			 prior to discharge. Facility, in terms of general preparation, should have
			 adequate equipment and supplies, provisions for proper record keeping, and the
			 ability to recover patients after anesthesia.
(3) Training required: The physician must be
			 able to document satisfactory completion of training such as being Board
			 certified or being an active candidate for certification by a Board approved by
			 the American Board of Medical Specialties or comparable formal training.
			 Alternative credentialing for procedures outside the physician's core
			 curriculum must be applied for through the Alabama Board of Medical Examiners
			 and must be approved by the Board. The physician and at least one assistant
			 must be currently trained in Advanced Cardiac Life Support (ACLS).
(4) Assistance of other personnel: Anesthesia
			 should be administered only by licensed, qualified and competent practitioners.
			 Practitioners must have documented competence and training to administer
			 moderate sedation/analgesia and to assist in any support or resuscitation
			 measures as required. The individual administering moderate sedation/analgesia
			 and/or monitoring the patient cannot assist the physician in performing the
			 surgical procedure. Scrub or Circulating nurse(s) and/or assistant(s) must be
			 trained in their specific job skills as determined by the supervising
			 physician. At least one physician currently trained in ACLS must be immediately
			 and physically available until the last patient is past the first stage of
			 recovery. At least one practitioner currently trained in ACLS must be
			 immediately and physically available until the last patient is discharged from
			 the facility.
Authors:
Alabama Board of Medical Examiners
ad hoc
Committee: Arthur F. Toole, III, M.D.; Jorge A. Alsip,
				M.D.; James G. Chambers, III, M.D.; Craig H. Christopher, M.D.; Alcus Ray
				Hudson, M.D.; Pamela D. Varner, M.D.; James E. West, M.D.; and Task Force
				Sub-Committee: Jeff Plagenhoef, M.D.; Eric Crum, M.D.; Dan J. Coyle, Jr., M.D.;
				Gary Monheit, M.D.; Robert Hurlbutt, IV, M.D.; C. Paul Perry, M.D.; W. Guinn
				Paulk, M.D.; Mark McIlwain, D.M.D., M.D.; Jerald Clanton, D.M.D., M.D.; Patrick
				J. Budny, M.D.; James W. Northington, M.D.; David Franco, M.D.; Thomas E.
				Moody, M.D.
Statutory Authority:
Code of Ala.
				  1975
, §
										34-24-53.