California Code of Regulations › Title 16 - Professional and Vocational Regulations › Division 13 - Medical Board of California › Chapter 2 - Enforcement › Article 1 - General Provisions › Section 1356.6 - Liposuction Extraction and Postoperative Care Standards

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A liposuction procedure that is performed
				  under general anesthesia or intravenous sedation or that results in the
				  extraction of 5,000 or more cubic centimeters of total aspirate shall be
				  performed in a general acute-care hospital or in a setting specified in Health
				  and Safety Code Section
				  1248.1.
(b) The following standards apply to any
				  liposuction procedure not required by subsection (a) to be performed in a
				  general acute-care hospital or a setting specified in Health and Safety Code
				  Section
				  1248.1:
(1) Intravenous Access and Emergency Plan.
				  Intravenous access shall be available for procedures that result in the
				  extraction of less than 2,000 cubic centimeters of total aspirate and shall be
				  required for procedures that result in the extraction of 2,000 or more cubic
				  centimeters of total aspirate. There shall be a written detailed plan for
				  handling medical emergencies and all staff shall be informed of that plan. The
				  physician shall ensure that trained personnel, together with adequate and
				  appropriate equipment, oxygen, and medication, are onsite and available to
				  handle the procedure being performed and any medical emergency that may arise
				  in connection with that procedure. The physician shall either have admitting
				  privileges at a local general acute-care hospital or have a written transfer
				  agreement with such a hospital or with a licensed physician who has admitting
				  privileges at such a hospital.
(2)
				  Anesthesia. Anesthesia shall be provided by a qualified licensed practitioner.
				  The physician who is performing the procedure shall not also administer or
				  maintain the anesthesia or sedation unless a licensed person certified in
				  advanced cardiac life support is present and is monitoring the
				  patient.
(3) Monitoring. The
				  following monitoring shall be
available
for volumes greater than
				  150 and less than 2,000 cubic centimeters of total aspirate and shall be
required
for volumes between 2,000 and 5,000 cubic centimeters of
				  total aspirate:
(A) Pulse oximeter
(B) Blood pressure (by manual or automatic
				  means)
(C) Fluid loss and
				  replacement monitoring and recording
(D) Electrocardiogram
(4) Records. Records shall be maintained in
				  the manner necessary to meet the standard of practice and shall include
				  sufficient information to determine the quantities of drugs and fluids infused
				  and the volume of fat, fluid and supranatant extracted and the nature and
				  duration of any other surgical procedures performed during the same session as
				  the liposuction procedure.
(5)
				  Discharge and Postoperative-care Standards.
(A) A patient who undergoes any liposuction
				  procedure, regardless of the amount of total aspirate extracted, shall not be
				  discharged from professionally supervised care unless the patient meets the
				  discharge criteria described in either the Aldrete Scale or the White Scale.
				  Until the patient is discharged, at least one staff person who holds a current
				  certification in advanced cardiac life support shall be present in the
				  facility.
(B) The patient shall
				  only be discharged to a responsible adult capable of understanding
				  postoperative instructions.