Md. Code Regs. 10.44.12.03

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.44.12.03 - Definitions

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) Accredited facility means a facility holding current certification from:

(a) The Accreditation Association for Ambulatory Health Care (AAAHC);

(b) The Joint Commission on Accreditation of Healthcare Organizations (JCAHO);

(c) The Joint Commission Ambulatory Health Care Accreditation (JCAHCA);

(d) The American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF); or

(e) Their successor organizations.

(2) "Administration evaluation" means an evaluation by the Board or its designee to determine if an applicant for a permit demonstrates knowledge of management of emergencies and anesthesia techniques to a level that meets the requirements of this chapter.

(3) "Advanced Cardiac Life Support (ACLS)" means a certification that an individual has successfully completed an advanced cardiac life support course offered by the American Heart Association or other entity approved by the Board.

(4) "Anesthesia" means an artificially induced insensibility to pain usually achieved by the administration of gases or the use of drugs.

(5) "Anesthesia and sedation" means:

(a) Moderate sedation;

(b) Deep sedation; and

(c) General anesthesia.

(6) Anxiolysis.

(a) Anxiolysis means a drug-induced state, with or without nitrous oxide/oxygen to decrease anxiety, in which patients respond normally to tactile stimulation and verbal commands. Although cognitive function and coordination may be impaired, ventilatory and cardiovascular functions are maintained and require no assistance.

(b) "Anxiolysis" includes a single dose of one sedative, narcotic, class of drugs, or medication prescribed by the treating dentist and taken the evening before a procedure or the morning of a procedure, or both, provided that the dosage complies with the definition of anxiolysis under §B(5)(a) of this regulation.

(c) Anxiolysis does not include the administering, prescribing, or dispensing of any other sedative, narcotic, class of drugs, or medication for the purpose of anesthesia by a dentist to a patient to be used for anesthesia or sedation, to be taken the evening before a procedure or the morning of a procedure.

(7) "Board" means the State Board of Dental Examiners.

(8) "Certified registered nurse anesthetist" means a registered nurse who is currently certified to practice nurse anesthesia in Maryland.

(9) "Deep sedation" means a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Cardiovascular function is usually maintained.

(10) "Dentist" means an individual who holds a current license to practice dentistry in Maryland.

(11) "Facility" means any location in which anesthesia or sedation is administered for the practice of dentistry.

(12) "Facility evaluation" means an on-site inspection by the Board or its designee to determine if a facility where the applicant proposes to provide anesthesia and sedation is adequately supplied, equipped, staffed, and maintained in a condition to support the provision of anesthesia and sedation services in a manner that meets the requirements of this chapter.

(13) "General anesthesia" means a drug-induced loss of consciousness during which patients are not arousable even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation, drug-induced depression, or changes in neuromuscular function. Cardiovascular function may be impaired.

(14) "General anesthesia administration permit" means a permit that was issued by the Board before January 4, 2010, that authorized the dentist to whom the permit was issued to administer general anesthesia for the practice of dentistry.

(15) "General anesthesia facility permit" means a permit that was issued by the Board before January 4, 2010, that authorized the administration of general anesthesia for the practice of dentistry in the facility named in the permit.

(16) "Incident" means dental treatment performed on a patient under moderate sedation, deep sedation, or general anesthesia with unforeseen complications.

(17) "Moderate enteral sedation" means a drug-induced depression of consciousness through the gastrointestinal tract or oral mucosa during which patients respond 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.

(18) "Moderate parenteral sedation" means a drug-induced depression of consciousness that bypasses the gastrointestinal tract or oral mucosa during which patients respond 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.

(19) "Moderate sedation" means a drug-induced depression of consciousness during which patients respond 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 maintained.

(20) "Parenteral" means a technique of administration in which the drug bypasses the gastrointestinal tract, that is, through an intramuscular, intravenous, intranasal, submucosal, subcutaneous, or intraosseous technique.

(21) "Parenteral sedation administration permit" means a permit that was issued by the Board before January 4, 2010, that authorized the dentist to whom the permit was issued to administer parenteral sedation for the practice of dentistry.

(22) "Parenteral sedation facility permit" means a permit that was issued by the Board before January 4, 2010, that authorized the administration of parenteral sedation for the practice of dentistry in the facility named in the permit.

(23) "Pediatric Advanced Life Support (PALS)" means a certification that an individual has successfully completed a pediatric advanced life support course offered by the American Heart Association or other entity approved by the Board.

(24) "Physician" means a physician, including a doctor of osteopathy, who holds a current license to practice medicine in Maryland.

(25) "Renewal evaluation" means an on-site inspection by the Board or its designee before the renewal of a permit to determine if a facility where the applicant proposes to provide anesthesia and sedation is adequately supplied, equipped, staffed, and maintained in a condition to support the provision of anesthesia and sedation services in a manner that meets the requirements of this chapter.

(26) "Sedation" means the reduction of stress or excitement by the administration of a drug that has a soothing, calming, or tranquilizing effect.

Md. Code Regs. 10.44.12.03

Regulations .03 under General Anesthesia, repealed, and new Regulations .03 under Anesthasia and Sedation, adopted effective January 4, 2010 (36:18 Md. R. 1380)
Regulation .03 amended effective 42:9 Md. R. 648, eff.5/11/2015