These services shall be available when the hospital provides surgery or obstetrical services with C-section capacity and shall be integrated with other services of the hospital and shall include at least the following:
01.
Policies and Procedures. Policies and procedures shall be approved by the medical staff and the administration of the hospital. These written policies and procedures shall include at least the following:
a. Designation of persons permitted to give anesthesia, types of anesthetics, preanesthesia, and post anesthesia responsibilities; and
b. Preanesthesia physical evaluation of a patient by an anesthetist, with the recording of pertinent information prior to surgery together with the history and physical and preoperative diagnosis of a physician; and
c. Review of patient condition immediately prior to induction; and
d. Safety of the patient during anesthetic period; and
e. Record of events during induction, maintenance, and emergence from anesthesia including:
i. Amount and duration of agents; and
ii. Drugs and IV fluids; and
iii. Blood and blood products.
f. Record of post-anesthetic visits and any complications shall be made within three (3) to forty-eight (48) hours following recovery; and
g. There shall be a written infection control procedure including aseptic techniques, and disinfection or sterilizing methods.
02.
Anesthesia Service Staff. Anesthesia service shall be under the overall direction of a physician. The medical staff or appropriate committee shall approve all persons granted anesthesia privileges.
a. All general anesthetics shall be given by a physician or certified nurse anesthetist; and
b. Responsibility shall be assigned for the development of procedures concerning patient safety, including a record of equipment inspection and maintenance. The procedures shall be approved by the physician director of the anesthesia service.
03.
Anesthesia Equipment and Supplies. There shall be at least the following immediately available:
a. Cardiac monitor; and
b. Defibrillator; and
c. Positive pressure breathing apparatus; and
d. Crash cart or equivalent with appropriate cardiopulmonary resuscitation equipment.
