Virginia Administrative Code › Title 18 - PROFESSIONAL AND OCCUPATIONAL LICENSING › Agency 85 - BOARD OF MEDICINE › Chapter 20 - REGULATIONS GOVERNING THE PRACTICE OF MEDICINE, OSTEOPATHIC MEDICINE, PODIATRY, AND CHIROPRACTIC › Part VIII - Office-Based Anesthesia › Section 18VAC85-20-310 - Definitions

Current through Register Vol. 40, No. 24, July 15, 2024
"Advanced resuscitative techniques" means methods learned
					 in certification courses for Advanced Cardiopulmonary Life Support (ACLS), or
					 Pediatric Advanced Life Support (PALS).
"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 often
					 require assistance in maintaining a patent airway, and spontaneous ventilation
					 may be inadequate. Cardiovascular function is usually maintained.
"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.
"Local anesthesia" means a transient and reversible loss of
					 sensation in a circumscribed portion of the body produced by a local anesthetic
					 agent.
"Minimal sedation/anxiolysis" means a drug-induced state
					 during which a patient responds normally to verbal commands. Although cognitive
					 function and coordination may be impaired, ventilatory and cardiovascular
					 functions are usually not affected.
"Moderate sedation/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 usually required to maintain a patent airway, and spontaneous
					 ventilation is usually adequate. Cardiovascular function is usually
					 maintained.
"Monitoring" means the continual clinical observation of
					 patients and the use of instruments to measure and display the values of
					 certain physiologic variables such as pulse, oxygen saturation, level of
					 consciousness, blood pressure and respiration.
"Office-based" means any setting other than (i) a licensed
					 hospital as defined in § 32.1-123 of the Code of Virginia or
					 state-operated hospitals or (ii) a facility directly maintained or operated by
					 the federal government.
"Physical status classification" means a description used
					 in determining the physical status of a patient as specified by the American
					 Society of Anesthesiologists. Classifications are Class 1 for a normal healthy
					 patient; Class 2 for a patient with mild systemic disease; Class 3 for a
					 patient with severe systemic disease limiting activity but not incapacitation;
					 Class 4 for a patient with incapacitating systemic disease that is a constant
					 threat to life; and Class 5 for a moribund patient not expected to live 24
					 hours with or without surgery.
"Regional anesthesia" means the administration of
					 anesthetic agents to a patient to interrupt nerve impulses without the loss of
					 consciousness and includes minor and major conductive blocks.
"Minor conductive block" means the injection of local
					 anesthesia to stop or prevent a painful sensation in a circumscribed area of
					 the body (local infiltration or local nerve block), or the block of a nerve by
					 refrigeration. Minor conductive nerve blocks include, but are not limited to,
					 peribulbar blocks, pudenal blocks and ankle blocks.
"Major conductive block" means the use of local anesthesia
					 to stop or prevent the transmission of painful sensations from large nerves,
					 groups of nerves, nerve roots or the spinal cord. Major nerve blocks include,
					 but are not limited to epidural, spinal, caudal, femoral, interscalene and
					 brachial plexus.
"Topical anesthesia" means an anesthetic agent applied
					 directly to the skin or mucous membranes, intended to produce a transient and
					 reversible loss of sensation to a circumscribed area.
Statutory Authority
§§ 54.1-2400 and 54.1-2912.1 of the Code of
						Virginia.