New Jersey Administrative Code › Title 13 - LAW AND PUBLIC SAFETY › Chapter 35 - BOARD OF MEDICAL EXAMINERS › Subchapter 4A - SURGERY, SPECIAL PROCEDURES AND ANESTHESIA SERVICES PERFORMED IN AN OFFICE SETTING › Section 13:35-4A.7 - Standards for administering or supervising the administration of anesthesia services in an office; pre-anesthesia counseling; patient monitoring; recovery; patient record; discharge of patient

Current through Register Vol. 56, No. 14, July 15, 2024
(a) A practitioner who administers or supervises the administration and monitoring of anesthesia services in an office shall be privileged by a hospital to provide the particular anesthesia service. If a practitioner is not privileged but wishes to administer or supervise the administration of anesthesia services, the practitioner shall apply to the Board pursuant to 13:35-4A.12 to seek Board-approved privileging.
(b) A practitioner who administers or supervises the administration and monitoring of anesthesia services in an office shall provide pre-anesthesia counseling and preparation as follows:
1. Any patient to whom anesthesia services are to be provided shall be appropriately screened by the individual administering anesthesia services. Patients who, by reason of pre-existing medical or other conditions, are at undue risk for complications (for example, morbidly obese patients; patients with severe cardiac, pulmonary, airway, or neurological problems; substance abusers) shall be referred to an appropriate specialist for a pre-procedure consultation or to another treatment setting or other appropriate facility. Only patients with an ASA physical status classification of I or II are appropriate candidates for an office surgery or special procedure for which general or regional anesthesia are to be used. Patients with an ASA physical classification of I, II, or III are appropriate candidates for moderate sedation.
2. A medical history shall be conducted including a review of abnormalities in any organ system; previous adverse experience with anesthesia services; any history of stridor, snoring or sleep apnea, or of advanced rheumatoid arthritis or spinal disorder; current medications being taken; drug allergies; or any history of substance abuse;
3. The risks and benefits of anesthesia and alternative methods or treatments shall be fully explained by the physician or certified registered nurse anesthetist (CRNA), and written informed consent for the anesthesia services contemplated shall be obtained from the patient, guardian or authorized representative;
4. An appropriate fasting protocol shall be explained and timely provided to the patient, guardian or authorized representative;
5. Pre-procedure laboratory test results shall be reviewed and recorded;
6. A focused physical examination shall be conducted, including auscultation of the heart and lungs, and an evaluation of the airway, particularly an assessment of anatomical abnormalities (that is, jaw, mouth, head and neck) which may increase the likelihood of an airway obstruction;
7. A plan of anesthesia shall be developed by the physician administering anesthesia services or personally reviewed by the supervising physician if the plan has been developed by other authorized personnel;
8. A patient shall be counseled prior to the procedure that the procedure will be canceled if the patient plans to drive home after the procedure and has not made arrangements to be accompanied home by an individual who accepts responsibility for the patient; and
9. Prior to the administration of anesthesia services, the physician shall ensure that the patient removes all cosmetics, jewelry, contact lenses, dental appliances and prosthetic devices which might reasonably jeopardize patient safety.