When anesthetic agents of any kind are administered, the dentist must comply with the requirements in this section.
(1) The anesthesia provider or anesthesia monitor shall record the patient's condition. The record must include documentation of all medications administered with dosages, regular and consistent time intervals, and route of administration. The provider administering the sedation may determine time intervals.
(2) All patients receiving any anesthetic agent including local anesthesia or minimal sedation with nitrous oxide, vital signs including, but not limited to, blood pressure and heart rate must be recorded, unless the cooperation of the patient or circumstances of the case will not allow it. If pretreatment vitals cannot be obtained, the reason or reasons why must be recorded. Obtaining vital signs on ASA 1 age 13 and under will be at the dentist's discretion.
(3) The following equipment must be available and include:
(a) Suction equipment capable of aspirating gastric contents from the mouth and pharynx;
(b) Portable oxygen delivery system including full face masks and a bag-valve-mask combination with appropriate connectors capable of delivering positive pressure, oxygen enriched ventilation to the patient;
(c) Blood pressure cuffor sphygmomanometer of appropriate size;
(d) Stethoscope or equivalent monitoring device.
(4) The following emergency drugs must be available and maintained:
(a) Bronchodilator including, but not limited to, albuterol;
(b) Sugar or glucose;
(c) Aspirin;
(d) Antihistaminic including, but not limited to, diphenhydramine;
(e) Coronary artery vasodilator including, but not limited to, nitroglycerin;
(f) Anti-anaphylactic agent including, but not limited to, epinephrine.
(5) A licensed dentist shall develop and maintain written emergency protocols and ensure:
(a) All staff are trained in the protocols wherever anesthetic agents of any kind are administered.
(b) The emergency preparedness written protocols include training requirements and procedures specific to the licensed dentist's equipment and drugs for responding to emergency situations involving sedation or anesthesia, including information specific to respiratory emergencies.
(c) The protocols are reviewed annually, updated as necessary, and the review is documented.
(d) The protocols include basic life support protocols, advanced cardiac life support protocols, or pediatric advanced life support protocols based on the level of anesthetics being administered.
(6) Equipment used for monitoring patients must be calibrated or performance verified according to manufacturer's instructions.
[Statutory Authority: RCW
18.32.0365 and
18.32.640. WSR 24-01-033, § 246-817-724, filed 12/11/23, effective 1/11/24; WSR 16-06-106, § 246-817-724, filed 3/1/16, effective 4/1/16; WSR 09-04-042, § 246-817-724, filed 1/30/09, effective 3/2/09.]