Section 313-12-II - SPECIFIC PRACTICE REQUIREMENTS - ADMINISTRATION OF NITROUS OXIDE ANALGESIAA.DENTAL HYGIENIST RESPONSIBILITIES(1)Limitations. A dental hygienist who is not authorized to administer nitrous oxide analgesia from the Board may, during nitrous oxide analgesia administration by the dentist, observe the gauges and advise the dentist of any changes in gauge indices or readings but shall not in any way or under any circumstances adjust, manipulate, or control the nitrous oxide apparatus or equipment. (2)Authorization. A dental hygienist issued a permit or authority to administer nitrous oxide analgesia may administer nitrous oxide analgesia utilizing induction via titration and not to exceed 50% concentration under the direct supervision of a dentist.B.DENTIST RESPONSIBILITIES(1) A dentist who is providing the direct supervision of the administration of nitrous oxide analgesia must: (a) Decide which patient will receive nitrous oxide analgesia and document this decision by note or prescription in the patient dental record;(b) Note in the patient dental record the condition of the patient's recovery prior to the patient's discharge; and(c) Utilize engineering controls and maintenance procedures to ensure safety of inhalation equipment.(2) A dentist who is supervising the delivery of nitrous oxide analgesia or providing the delivery of nitrous oxide analgesia to a patient is responsible to ensure that any nitrous oxide delivery system within the dental practice adheres to the hazard controls recommendations of nitrous oxide during anesthetic administration as established by the following publications of the U.S. Department of Health and Human Services ("DHHS"), CDC, National Institute for Occupational Safety and Health (NIOSH): (a) DHHS (NIOSH) Publication No. 94-100, "Controlling Exposures to Nitrous Oxide During Anesthetic Administration"(b) DHHS (NIOSH) Publication No. 94-118, "NIOSH Warns: Nitrous Oxide Continues to Threaten Health Care Workers" and(c) DHHS (NIOSH) Publication No. 96-107, "Control of Nitrous Oxide in Dental Operatories." Copies of the foregoing publications may be obtained on line at http://www.cdc.gov/niosh/pubs.html by calling 1-800-356-4674, or by writing to the physical address at:
NIOSH
4676 Columbia Parkway, Mail Slot C-13
Cincinnati, OH 45226
02-313 C.M.R. ch. 12, § II