Alabama Administrative Code › Title 540 - ALABAMA BOARD OF MEDICAL EXAMINERS › Chapter 540-X-10 - OFFICE-BASED SURGERY › Section 540-X-10-.07 - Standards For Office-Based Procedures - Deep 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.8
(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. 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 deep
			 sedation/analgesia and to assist in any support or resuscitation measures as
			 required. The individual administering deep 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.