Wyoming Administrative Code › Agency 034 - Dental Examiners, Board of › Sub-Agency 0001 - Dental Examiners, Board of › Chapter 5 - ANESTHESIA ADMINISTRATION AND SEDATION PERMIT PROCEDURES › Section 5-3 - Definitions

Current through July 13, 2024
For the purpose of this chapter, the following definitions
				  shall apply:
(a) "ACLS" means advanced
				cardiac life support.
(b)
				"Anxiolysis" is minimal sedation.
(c) "Applicant" means a Wyoming licensed
				dentist applying for a sedation permit.
(d) "ASA" means American Society of
				Anesthesiology classification.
(e)
				"Combination inhalation" means using an inhalation agent and a sedative agent
				at the same time.
(f) "Competent"
				means displaying special skill or knowledge derived from training and
				experience.
(g) "Deep sedation"
				means a drug-induced depression of consciousness during which the patient
				cannot be easily aroused but responds purposefully following repeated or
				painful stimulation. The ability to independently maintain ventilatory function
				may be impaired. The patient may require assistance in maintaining a patent
				airway, and spontaneous ventilation may be inadequate. Cardiovascular function
				is usually maintained.
(h) "Dental
				hygienist" means a Wyoming licensed dental hygienist holding an appropriate
				expanded duties permit including local anesthesia and/or nitrous oxide
				anxiolysis.
(i) "Enteral" means a
				route of administration in which the agent is absorbed through the
				gastrointestinal tract or mucosa [i.e., oral, rectal, nasal, or
				sublingual].
(j) "Facility Permit"
				means a permit issued to any location where sedation is being performed that
				has been inspected and approved by the Board.
(k) "Facility Permit Holder" means a Wyoming
				licensed dentist designated as the responsible dentist for a facility
				permit.
(l) "General anesthesia"
				means a drug-induced loss of consciousness during which the patient is not
				arousable, even by painful stimulation. The ability to independently maintain
				ventilatory function is often impaired. The patient often requires 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.
(m) "Inhalation" means a
				route of administration in which a gaseous or volatile agent is introduced into
				the pulmonary tree and whose primary effect is due to absorption through the
				pulmonary bed.
(n) "Local
				anesthesia" means the elimination of sensation, especially pain, in one part of
				the body by the topical application or regional injection of a drug.
(o) "Minimal sedation" (previously known as
				anxiolysis) 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. Minimal
				sedation includes administration of oral medication and/or nitrous
				oxide.
(p) "Moderate sedation"
				previously known as "conscious sedation and/or twilight sedation or parenteral
				sedation" means a drug-induced depression of consciousness during which the
				patient responds 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. The drugs and/or techniques used should carry a margin
				of safety wide enough to render unintended loss of consciousness unlikely.
				Repeated dosing of an agent before the effects of previous dosing can be fully
				appreciated may result in a greater alteration of the state of consciousness
				than is the intent of the sedation permit holder. Further, a patient whose only
				response is reflex withdrawal from a painful stimulus is not considered to be
				in a state of moderate sedation.
(q) "MRD" means maximum recommended dose of a
				drug as printed on Food and Drug Administration approved labeling for
				unmonitored home use.
(r) "Nitrous
				oxide anxiolysis" means 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.
(s) "PALS" means Pediatric
				Advanced Life Support.
(t)
				"Parenteral" means a route of administration in which the drug bypasses the
				gastrointestinal tract [i.e., intramuscular, intravenous, intranasal,
				submucosal, subcutaneous, or intraosseous].
(u) "Qualified anesthesia provider" means a
				licensed anesthesiologist, certified registered nurse anesthetist, or sedation
				permit holder with appropriate sedation level permit.
(v) "Responsible dentist" means a licensed
				dentist who assumes responsibility for a facility permit.
(w) "Sedation Inspector" means a
				Board-approved inspector of sedation facilities and sedation permit applicant's
				surgical/anesthetic technique cases.
(x) "Sedation permit" means a permit issued
				by the Board for administration of moderate sedation or deep sedation and/or
				general anesthesia by a sedation permit holder.
(y) "Titration" means administration of
				multiple or incremental doses of a drug until a desired effect is reached.
				Knowledge of each drug's time of onset, peak response, and duration of action
				is essential to avoid over sedation. Although the concept of titration of a
				drug to effect is critical for patient safety, when the intent is moderate
				sedation one must know whether the previous dose has taken full effect before
				administering an additional drug increment.