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ARIZONA STATE SENATE
Fifty-Sixth Legislature, First Regular Session
dental anesthesia; requirements
Purpose
Allows a qualified anesthesia provider to administer general anesthesia and deep sedation in dental offices and clinics. Outlines requirements for administering general anesthesia and deep sedation in dental offices and clinics.
Background
The Arizona State Board of Dental Examiners (BODEX) is established to promote the safe and professional practice of dentistry. The mission of BODEX is to provide professional, courteous service and information to the dental profession and the general public through: 1) the examination and licensure process; 2) the complaint adjudication and enforcement processes; and 3) the protection of oral health, safety and welfare of Arizona citizens through a fair and impartial system.
BODEX is charged with the investigation of complaints regarding dental professionals and related business entities, which are resolved through: 1) the issuing of a letter of concern; 2) the issuing of decrees of censure; 3) fixing periods and terms of probation; 4) suspending or revoking licenses, certificates and restricted permits; and 5) reinstating licenses, certificates and restricted permits in proper cases.
Statute also directs BODEX by rule to: 1) require that a dental licensee obtain a permit for applying general anesthesia, semiconscious sedation or conscious sedation; 2) establish and collect a fee of not more than $300 to cover administrative costs connected with issuing the permit; and 3) conduct inspections to ensure compliance (A.R.S. § 32-1207).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Allows a BODEX licensee who has not obtained a permit for applying general anesthesia, semiconscious sedation or conscious sedation to perform dental procedures on a patient who receives an anesthetic administered by a qualified anesthesia provider who is exclusively responsible for the preoperative, intraoperative and postoperative anesthetic management of the patient.
2. Allows the Arizona Medical Board (AMB) to issue permits to administer general anesthesia and deep sedation in dental offices and clinics to doctors of medicine who have completed residency training in anesthesiology.
3. Allows the Arizona Board of Osteopathic Examiners in Medicine and Surgery (ABOE) to issue permits to administer general anesthesia and deep sedation in dental offices and clinics to physicians who have completed residency training in anesthesiology.
4. Allows the Arizona Board of Nursing (AZBN) to issue permits to administer general anesthesia and deep sedation in dental offices and clinics to certified registered nurse anesthetists who have certification in anesthesiology.
5. Requires a dental office or dental clinic at which general anesthesia or deep sedation is administered to contain the following properly operated equipment and supplies when administering general anesthesia or deep sedation:
a) an electrocardiograph monitor;
b) a pulse oximeter;
c) a cardiac defibrillator or automated external defibrillator;
d) positive pressure oxygen and supplemental oxygen;
e) suction equipment, including an endotracheal, tonsillar or pharyngeal and an emergency backup medical suction device;
f) a laryngoscope, multiple blades, backup batteries and bulbs;
g) endotracheal tubes and appropriate connectors;
h) magill forceps;
i) oropharyngeal and nasopharyngeal airways;
j) auxiliary lighting;
k) a stethoscope;
l) a blood pressure monitoring device; and
m) a capnography monitoring device.
6. Requires the health care personnel at a dental office or clinic at which general anesthesia or deep sedation is administered to be capable of handling procedures related to complications and emergency incidents.
7. Requires the health care personnel involved in administering and monitoring general anesthesia or deep sedation to hold a current health care provider level course completion confirmation in cardiopulmonary resuscitation.
8. Requires a qualified anesthesia provider, within two years before administering general anesthesia or deep sedation in a dental office or clinic, to have completed coursework in one or more of the following:
a) advance cardiac life support;
b) pediatric advance life support, if working in a practice treating pediatric patients; or
c) a recognized continuing education course in advanced airways management.
9. Requires a qualified anesthesia provider to ensure that the dental office or clinic at which general anesthesia or deep sedation is administered complies with the equipment and emergency procedure requirements before administering general anesthesia or deep sedation.
10. Requires the qualified anesthesia provider to submit a completed affidavit verifying compliance with dental anesthesia requirements to both BODEX and the regulatory board that licenses the qualified anesthesia provider.
11. Allows BODEX to conduct on-site evaluations of any dental office or clinic at which general anesthesia or deep sedation is administered to verify compliance.
12. Asserts that a qualified anesthesia provider who is licensed by BODEX that fails to comply with dental anesthesia requirements commits an act that constitutes a danger to the health, welfare or safety of the public.
13. Requires BODEX to promptly report a qualified anesthesia provider to the regulatory board that licenses the provider if the qualified anesthesia provider who is not licensed by BODEX fails to comply with the dental anesthesia requirements.
14. Requires BODEX to promptly report an adverse anesthesia outcome to the regulatory board that licenses the qualified anesthesia provider, if the adverse outcome involves a provider who is not licensed by BODEX.
15. Requires BODEX to suspend the qualified anesthesia provider's permit to administer anesthesia until the investigation of the adverse anesthesia outcome is complete, if a provider licensed by BODEX is involved in the adverse outcome.
16. Requires BODEX to promptly report a death to the regulatory board that licenses the qualified anesthesia provider, if a provider who is not licensed by BODEX is involved in an adverse anesthesia outcome that results in death of a patient.
17. Requires the regulatory board to suspend the qualified anesthesia provider's permit to administer anesthesia until the investigation into the adverse outcome that results in death is complete.
18. Defines qualified anesthesia provider as:
a) a licensee who hold a permit to administer anesthesia and deep sedation by BODEX;
b) a physician who has completed residency training in anesthesiology and who is licensed by the AMB or the ABOE and permitted to administer anesthesia in dental offices or clinics; and
c) a certified registered nurse anesthetist who has a national board certification in anesthesiology and who is licensed by the AZBN and permitted to administer anesthesia in dental offices and clinics.
19. Makes technical changes.
20. Becomes effective on the general effective date.
Prepared by Senate Research
February 13, 2023
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