Iowa Administrative Code › Agency 650 - Dental Board › Title V - Professional Standards › Chapter 29 - Sedation and Nitrous Oxide › Rule 650-29.1 - Definitions

Current through Register Vol. 47, No. 3, July 24, 2024
For the purpose of these rules, relative to the
				  administration of deep sedation, general anesthesia, moderate sedation, minimal
				  sedation, and nitrous oxide inhalation analgesia by licensed dentists, the
				  following definitions shall apply:
"ACC"
means the anesthesia credentials
				  committee of the board.
"ASA "
refers to the American Society of
				  Anesthesiologists Patient Physical Status Classification System. Category I
				  means normal healthy patients, and category II means patients with mild
				  systemic disease. Category III means patients with severe systemic disease, and
				  category IV means patients with severe systemic disease that is a constant
				  threat to life.
"Board"
means the Iowa dental board
				  established in Iowa Code section
				  147.14(1)
"d. "
"Capnography"
means the monitoring of the
				  concentration of exhaled carbon dioxide in order to assess physiologic status
				  or determine the adequacy of ventilation during anesthesia.
"Current ACLS or PALS certification "
means
				  current certification in advanced cardiac life support (ACLS) or pediatric
				  advanced life support (PALS). Current certification means certification by an
				  organization on an annual basis or, if that certifying organization requires
				  certification on a less frequent basis, evidence that the individual has been
				  properly certified for each year covered by the renewal period. The course for
				  the purposes of certification must include a clinical component.
"DAANCE"
means the dental anesthesia
				  assistant national certification examination as offered by the American
				  Association of Oral and Maxillofacial Surgeons (AAOMS).
"Deep sedation "
means drug-induced
				  depression of consciousness during which patients cannot be easily aroused but
				  respond purposefully following repeated painful stimulation. The ability to
				  independently maintain ventilatory function may be impaired. Patients may
				  require assistance in maintaining a patent airway, and spontaneous ventilation
				  may be inadequate. Cardiovascular function is usually maintained.
"Facility "
means any dental office or
				  clinic where sedation is used in the practice of dentistry. The term "facility"
				  does not include a hospital.
"General anesthesia"
means a drug-induced
				  loss of consciousness during which patients are not arousable, even by painful
				  stimulation. The ability to independently maintain ventilatory function is
				  often impaired. Patients often require assistance in maintaining a patent
				  airway, and positive pressure ventilation may be required because of depressed
				  spontaneous ventilation or drug-induced depression of neuromuscular function.
				  Cardiovascular function may be impaired.
"Licensed sedation provider"
means a
				  physician anesthesiologist currently licensed by the Iowa board of medicine or
				  a certified registered nurse anesthetist (CRNA) currently licensed by the Iowa
				  board of nursing.
"Minimal sedation"
means a minimally
				  depressed level of consciousness produced by a pharmacological method that
				  retains the patient's ability to independently and continuously maintain an
				  airway and respond normally to tactile stimulation and verbal command. Although
				  cognitive function and coordination may be modestly impaired, ventilatory and
				  cardiovascular functions are unaffected. A patient whose only response reflex
				  is withdrawal from repeated painful stimuli is not considered to be in a state
				  of minimal sedation.
"Moderate sedation"
means a drug-induced
				  depression of consciousness, either by enteral or parenteral means, during
				  which patients respond purposefully to verbal commands, either alone or
				  accompanied by light tactile stimulation. No interventions are required to
				  maintain a patent airway, and spontaneous ventilation is adequate.
				  Cardiovascular function is usually maintained. A patient whose only response
				  reflex is withdrawal from a painful stimulus is not considered to be in a state
				  of moderate sedation.
"Monitoring nitrous oxide inhalation
				  analgesia"
means continually observing the patient receiving nitrous
				  oxide and recognizing and notifying the dentist of any adverse reactions or
				  complications.
"MRD"
means the manufacturer's maximum
				  recommended dose of a drug as printed in FDA-approved labeling.
"Nitrous oxide inhalation analgesia"
refers
				  to the administration by inhalation of a combination of nitrous oxide and
				  oxygen producing an altered level of consciousness that retains the patient's
				  ability to
independently and continuously maintain an airway and respond
				  appropriately to physical stimulation or verbal command.
"Patient monitor"
means a dental assistant,
				  dental hygienist, nurse or dentist whose primary responsibility is to
				  continuously monitor a patient receiving moderate sedation, deep sedation or
				  general anesthesia until the patient meets the criteria to be discharged to the
				  recovery area.
"Pediatric"
means patients aged 12 or
				  under.
"Permit holder "
means an Iowa licensed
				  dentist who has been issued a moderate sedation or general anesthesia permit by
				  the board.
"Time-oriented anesthesia record"
means
				  documentation at appropriate time intervals of drugs, doses and physiologic
				  data obtained during patient monitoring.