New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43A - MANUAL OF STANDARDS FOR LICENSING OF AMBULATORY CARE FACILITIES › Subchapter 12 - SURGICAL AND ANESTHESIA SERVICES › Section 8:43A-12.2 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
The following words and terms, when used in this subchapter, shall
				  have the following meanings, unless the context clearly indicates otherwise;
"Advanced Cardiac Life Support" (ACLS) means that an individual
				  has successfully completed a course of training offered by an individual who is
				  currently certified as an instructor by the American Heart Association or by a
				  recognized accrediting organization appropriate to the licensee's field of practice.
				  For example, for those treating adult patients, training in ACLS is appropriate and
				  for those treating children, training in pediatric advanced life support (PALS) is
				  appropriate.
"Analgesia" means the absence of the sensibility to pain without
				  loss of consciousness or decrease in the intensity of pain.
"Anesthesia" consists of general anesthesia and spinal or regional
				  anesthesia. It does not include local anesthesia.
"Anesthesiologist" means a physician who has successfully
				  completed an approved residency program in anesthesiology, or who is a diplomate of
				  either the American Board of Anesthesiology or the American Osteopathic Board of
				  Anesthesiology, or who was made a Fellow of the American College of Anesthesiology
				  before 1982.
"Anesthetic agent" means any drug or combination of drugs
				  administered with the purpose of creating conscious sedation, deep sedation,
				  regional anesthesia, or general anesthesia.
"Anesthetizing location" means any location in a health care
				  facility where anesthetic agents are administered.
"Certified registered nurse anesthetist" (CRNA) means a registered
				  professional nurse who is licensed by the New Jersey State Board of Nursing and who
				  holds current certification under a program governed or approved by the American
				  Association of Nurse Anesthetists (AANA), and who meets the conditions for practice
				  as set forth at N.J.A.C. 13:37-13.1.
"Conscious sedation" means a drug induced depression of
				  consciousness during which patients respond purposefully to verbal commands, either
				  alone or accompanied by light tactile stimulation. No interventions are required to
				  maintain an open airway, and spontaneous ventilation is adequate. Adequate
				  cardiovascular function is usually maintained. Within the context of this
				  subchapter, "conscious sedation" shall be synonymous with the term
				  "sedation/analgesia" as used by the American Society of Anesthesiologists.
"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 may be impaired. Patients may require assistance in maintaining a patent
				  airway and spontaneous ventilation may be inadequate. Cardiovascular function is
				  usually maintained.
"Epidural" means an anesthetic injected into the epidural space
				  surrounding the fluid filled sac (the dura) around the spine which partially numbs
				  the abdomen and legs.
"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 patient 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.
"Labor analgesia" means the reduction or management of pain during
				  labor, which involves the use of anesthetic agents and/or an epidural.
"Local anesthesia" consists of drugs or agents which produce a
				  transient and reversible loss of sensation in a circumscribed portion of the
				  body.
"Major regional anesthesia" means nerve blocks such as epidural,
				  caudal, axillary, brachial, and spinal anesthesia.
"Minor regional block" means the injection of a local anesthetic
				  to stop a painful sensation in a severely circumscribed area of the body (local
				  infiltration or local nerve block), or the block of a nerve by direct pressure and
				  refrigeration.
"Minor surgery" means surgery which can safely and comfortably be
				  performed on a patient who has received no more than the maximum manufacturer
				  recommended dose of local or topical anesthesia, without more than minimal
				  pre-operative medication or minimal intraoperative tranquilization and where the
				  likelihood of complications requiring hospitalization is remote. Minor surgery
				  specifically excludes all procedures performed utilizing anesthesia services as
				  defined in this section. Minor surgery also specifically excludes procedures which
				  may be performed under local anesthesia, but which involve intensive manipulation or
				  removal of tissue such as liposuction or lipo-injection, breast augmentation or
				  reduction, and removal of breast implants. Minor surgery includes the excision of
				  moles, warts, cysts, lipomas, skin biopsies, the repair of simple lacerations, or
				  other surgery limited to the skin and tissue. Additional examples of minor surgery
				  include closed reduction of a fracture, the incision and drainage of abscesses,
				  certain simple ophthalmologic surgical procedures, such as treatment of chalazions
				  and non-invasive ophthalmologic laser procedures performed with topical anesthesia,
				  limited endoscopies , such as , flexible sigmoidoscopies, anoscopies, proctoscopies,
				  arthrocenteses, thoracenteses , and paracenteses. Minor surgery shall not include
				  any procedure identified as "major surgery" within the meaning at
				  N.J.A.C.
				  13:35-4.1.
"Monitoring" means the observation of a patient including the use
				  of instruments to measure, display, and/or record (continuously or intermittently)
				  the values of certain physiologic variables such as temperature, pulse, respiration,
				  blood pressure, and oxygen saturation.
"Operating room" means a unit for the performance of
				  surgery.
"Pain management" means the administration of drugs to a patient,
				  which are not intended to result in a loss of consciousness, awareness or defensive
				  reflexes, but which are intended to alleviate pain occurring in the absence of an
				  invasive, operative, or manipulative procedure.
"Practitioner" means a licensed physician, dentist or
				  podiatrist.
"Privileges" means having been granted permission by a facility to
				  provide specified anesthesia services, such as the administration or supervision of
				  one or more types of anesthetic agents or procedures.
"Regional anesthesia" means the administration of anesthetic
				  agents to interrupt nerve impulses.
"Registered nurse anesthetist" means an individual who is a
				  qualified candidate for certification under a program governed or approved by the
				  American Association of Nurse Anesthetists (AANA), subject to the limitations and
				  restrictions established by the New Jersey State Board of Nursing (N.J.A.C.
				  13:37-13.2, Practice pending the results of the examination).
"Special procedure" means various diagnostic or therapeutic
				  interventions which may require the administration of sedation, analgesia, or
				  anesthesia. Examples include, but are not limited to: endoscopy, oral surgery,
				  radiologic procedures or emergency procedures.
"Special procedure room" means the appropriately equipped facility
				  location in which special procedures are performed.
"Supervision" means responsibility by a physician who has obtained
				  facility privileges in accordance with medical staff bylaws, and is immediately
				  available on-site overseeing the administration and monitoring of anesthesia.
Immediately available on-site means that the supervising physician
				  is present and is available to respond and proceed immediately to the anesthetizing
				  location.
"Universal precautions" means a set of precautions, in accordance
				  with Centers for Disease Control and Prevention published guideline for Handwashing
				  and Hospital Environmental Control. (Centers for Disease Control and Prevention
				  Guideline for Prevention of Surgical Site Infections (1999) (Infection Control and
				  Hospital Epidemiology 1999; 20:247-278), incorporated herein by reference, as
				  amended and supplemented. That publication may be obtained by telephoning the
				  Centers for Disease Control and Prevention at (800) 311-3435.)