D.C. Mun. Regs. tit. 17, r. 17-10709

Current through Register Vol. 71, No. 49, December 6, 2024
Rule 17-10709 - PERSONNEL AND EQUIPMENT REQUIREMENTS
10709.1

A dentist or dental facility with a Class I certification shall ensure that the following requirements are met before administering moderate sedation:

(a) A dentist qualified and certified to administer moderate sedation shall administer the moderate sedation;
(b) At least two (2) additional persons trained in Basic Life Support for Healthcare Providers shall be present in addition to the dentist, one of whom is trained in PALS if the patient is age twelve (12) or under;
(c) When the dentist administering the moderate sedation is also the same dentist performing the dental procedure, one of the other trained personnel present shall be designated to perform the patient monitoring. The person designated to perform the monitoring shall be trained in PALS if the patient is age twelve (12) or under;
(d) A positive-pressure oxygen delivery system suitable for the patient being treated shall be immediately available;
(e) Documentation of compliance with manufacturer's recommended maintenance of monitors, anesthesia delivery systems, and other anesthesia-related equipment shall be maintained;
(f) A pre-procedural check of equipment for each administration of sedation shall be performed;
(g) When inhalation equipment is used, it shall have a fail-safe system that is appropriately checked and calibrated;
(h) The equipment shall also have either (1) a functioning device that prohibits the delivery of less than thirty percent (30%) oxygen or (2) an appropriately calibrated and functioning in-line oxygen analyzer with audible alarm;
(i) The equipment necessary for monitoring end-tidal carbon dioxide and auscultation of breath sounds shall be immediately available;
(j) An appropriate scavenging system shall be utilized if gases other than oxygen or air are used;
(k) The equipment necessary to establish intravascular or intraosseous access shall be available until the patient meets discharge criteria; and
(l) A pulse oximeter shall be used.
10709.2

A dentist or dental facility with a Class II certification shall ensure that the following requirements are met before administering deep sedation:

(a) A dentist qualified and certified to administer deep sedation shall administer the deep sedation;
(b) At least two (2) additional persons trained in Basic Life Support for Healthcare Providers shall be present in addition to the dentist, one of which shall be trained in ACLS and if the patient is age twelve (12) or under shall also be trained in PALS;
(c) When the dentist administering the deep sedation is also the same dentist performing the dental procedure, one of the other trained personnel present shall be designated to perform the patient monitoring. The person designated to perform the monitoring shall be trained in ACLS and if the patient is age twelve (12) or under shall also be trained in PALS;
(d) A positive-pressure oxygen delivery system suitable for the patient being treated shall be immediately available;
(e) Documentation of compliance with manufacturer's recommended maintenance of monitors, anesthesia delivery systems, and other anesthesia-related equipment shall be maintained;
(f) Perform a pre-procedural check of equipment for each administration of sedation;
(g) When inhalation equipment is used, it shall have a fail-safe system that is appropriately checked and calibrated;
(h) The equipment shall also have either (1) a functioning device that prohibits the delivery of less than thirty percent (30%) oxygen or (2) an appropriately calibrated and functioning in-line oxygen analyzer with audible alarm;
(i) The equipment necessary for monitoring end-tidal carbon dioxide and auscultation of breath sounds shall be utilized;
(j) An appropriate scavenging system shall be utilized if gases other than oxygen or air are used;
(k) The equipment necessary to establish intravenous access shall be available;
(l) The equipment and drugs necessary to provide advanced airway management, and advanced cardiac life support shall be immediately available;
(m) Resuscitation medications and an appropriate defibrillator shall be immediately available; and
(n) A pulse oximeter shall be used.
10709.3

A dentist or dental facility with a Class III certification shall ensure that the following requirements are met before administering general anesthesia:

(a) A dentist qualified and certified to administer general anesthesia shall administer the general anesthesia;
(b) At least three (3) additional persons trained in Basic Life Support for Healthcare Providers shall be present in addition to the dentist, one of which shall be trained in ACLS or if the patient is age twelve (12) or under shall also be trained in PALS;
(c) When the dentist administering the general anesthesia is also the same dentist performing the dental procedure, one of the other trained personnel present shall be designated to perform the patient monitoring. The person designated to perform the monitoring shall be trained in ACLS and if the patient is age twelve (12) or under shall also be trained in PALS;
(d) A positive-pressure oxygen delivery system suitable for the patient being treated shall be immediately available;
(e) Documentation of compliance with manufacturer's recommended maintenance of monitors, anesthesia delivery systems, and other anesthesia-related equipment shall be maintained;
(f) A pre-procedural check of equipment for each administration of general anesthesia shall be performed;
(g) When inhalation equipment is used, it shall have a fail-safe system that is appropriately checked and calibrated;
(h) The equipment shall also have either (1) a functioning device that prohibits the delivery of less than thirty percent (30%) oxygen or (2) an appropriately calibrated and functioning in-line oxygen analyzer with audible alarm;
(i) The equipment necessary for monitoring end-tidal carbon dioxide and auscultation of breath sounds shall be utilized;
(j) An appropriate scavenging system shall be utilized if gases other than oxygen or air are used;
(k) The equipment necessary to establish intravenous access shall be available;
(l) Equipment and drugs necessary to provide advanced airway management, and advanced cardiac life support shall be immediately available;
(m) Resuscitation medications and an appropriate defibrillator shall be immediately available;
(n) A pulse oximeter shall be used; and
(o) Continuous ECG monitoring of patients is required.

D.C. Mun. Regs. tit. 17, r. 17-10709

Final Rulemaking published at 67 DCR 8806 (7/17/2020)