Kentucky Administrative Regulations › Title 201 - GENERAL GOVERNMENT CABINET › Chapter 8 - Board of Dentistry › Section 201 KAR 8:550 - Anesthesia and sedation related to dentistry

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				313.035
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				313.035(1) requires the
				board to promulgate administrative regulations related to anesthesia and
				sedation permits. The administration of local anesthesia, sedation, and general
				anesthesia is an integral part of dentistry and the foundation of pain control.
				This administrative regulation establishes requirements for permits to perform
				sedation or anesthesia associated with dentistry.
Section 1. Definitions.
(1) "Analgesia" means the diminution or
			 elimination of pain.
(2) "ADA"
			 means American Dental Association.
(3) "ASA" means American Society of
			 Anesthesiologists.
(4) "Continual"
			 means repeated regularly and frequently in steady succession.
(5) "Continuous" means prolonged without any
			 interruption.
(6) "Deep sedation"
			 means a drug-induced depression of consciousness during which patients cannot
			 be easily aroused but respond purposefully following repeated or painful
			 stimulation. The ability to independently maintain ventilatory function could
			 be impaired. The patient might require assistance in maintaining a patent
			 airway, and spontaneous ventilation could be inadequate. Cardiovascular
			 function is usually maintained.
(7)
			 "Enteral" means a technique of administration in which the agent is absorbed
			 through the gastrointestinal (GI) tract or oral mucosa (oral, rectal, or
			 sublingual).
(8) "General
			 anesthesia" means a drug-induced loss of consciousness during which a patient
			 is 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
			 could be required because of depressed spontaneous ventilation or drug-induced
			 depression of neuromuscular function. Cardiovascular function might be
			 impaired.
(9) "Immediately
			 available" means onsite at the facility and available for immediate
			 use.
(10) "Local anesthesia" means
			 the elimination or diminution of sensation, especially pain, in one (1) part of
			 the body by the topical application or regional injection of a drug.
(11) "Maximum Recommended Dose" or "MRD"
			 means the maximum FDA-recommended dose of a drug for minimal sedation, as
			 printed in FDA-approved labeling for unmonitored home use.
(12) "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 might be modestly impaired, ventilatory and
			 cardiovascular functions are unaffected.
(13) "Moderate sedation" means a drug-induced
			 depression of consciousness during which patients respond purposefully to
			 verbal commands, either alone or accompanied by light tactile stimulation.
			 Intervention is not required to maintain a patent airway, and spontaneous
			 ventilation is adequate. Cardiovascular function is usually maintained. This
			 term includes the enteral administration of drugs exceeding the maximum
			 recommended dose during a single appointment.
(14) "Nitrous oxide sedation" or "N2O
			 sedation" means a technique of inhalation sedation with nitrous oxide and
			 oxygen.
(15) "Operating dentist"
			 means a licensed dentist with primary responsibility for providing dental care
			 during a procedure
(16) "Pediatric
			 patient" means a patient twelve (12) years of age or younger.
(17) "Qualified anesthesia provider" means a
			 licensed anesthesiologist, Certified Registered Nurse Anesthetist, or dentist
			 with an applicable sedation permit.
(18) "Qualified dentist" means a licensed
			 dentist with an applicable sedation permit. A qualified dentist can also be an
			 operating dentist if they fulfill the requirement of subsection (15) of this
			 section.
(19) "Time-oriented
			 anesthesia record" means documentation at appropriate time intervals of drugs
			 administered, doses of drugs administered, and physiologic patient data
			 obtained during patient monitoring.
(20) "Trained individual" means personnel
			 with an active certification in Basic Life Support for Healthcare Providers,
			 who has been trained in monitoring EKG's, pulse oximetry, blood pressures,
			 airway management, and capnography. Training, whether formal or internal, is
			 documented in employee records.