Alabama Administrative Code › Title 540 - ALABAMA BOARD OF MEDICAL EXAMINERS › Chapter 540-X-10 - OFFICE-BASED SURGERY › Section 540-X-10-.08 - Standards For Office-Based Procedures - General And Regional Anesthesia

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.9
(2) Equipment and
			 supplies: Emergency resuscitation equipment, suction and a reliable source of
			 oxygen with a backup tank must be readily available. When triggering agents are
			 in the office, at least 12 ampules of dantrolene sodium must be readily
			 available within 10 minutes with additional ampules available from another
			 source. Monitoring equipment should include: blood pressure apparatus,
			 stethoscope, pulse oximetry, continuous EKG, capnography, and temperature
			 monitoring for procedures lasting longer than thirty (30) minutes. Monitoring
			 equipment and supplies should be in compliance with currently adopted ASA
			 standards 10. Facility, in terms of general preparation, must 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
			 general and regional anesthesia and to assist in any support or resuscitation
			 measures as required. The individual administering general and regional
			 anesthesia 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. Direction of the sedation/analgesia component of the
			 medical procedure should be provided by a physician who is immediately and
			 physically present, who is licensed to practice medicine in the state of
			 Alabama, and who is responsible for the direction of administration of the
			 anesthetic. The physician providing direction should assure that an appropriate
			 pre-anesthetic examination is performed, assure that qualified practitioners
			 participate, be available for diagnosis treatment and management of anesthesia
			 related complications or emergencies, and assure the provision of indicated
			 post anesthesia care. 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 11.
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.