Current through Register Vol. 48, No. 38, September 20, 2024
a) In a physician's office, the operating
physician shall have training and experience in the delivery of anesthesia
services in order to administer anesthesia or to enter into a practice
agreement with a certified registered nurse anesthetist (CRNA) to provide
anesthesia services in the office pursuant to Section 54.5 of the Medical
Practice Act and Section 15-25 of the Nursing and the Advanced Practice Nursing
Act [225 ILCS 65 ]. When an anesthesiologist is administering anesthesia in a
physician's office, the operating physician is not required to have the
training and experience set forth in subsection (b). A physician's office is
any practice location not regulated by Section 10.7 of the Hospital Licensing
Act [210 ILCS 85 ] or Section 6.5 of the Ambulatory Surgical Treatment Center
Act [210 ILCS 5 ].
b) The training
and experience requirements may be met in the manner specified in either
subsection (b)(1) or (2):
1) The physician
maintains clinical privileges to administer anesthesia services in a hospital
licensed in accordance with the Hospital Licensing Act or an ambulatory
surgical treatment center licensed in accordance with the Ambulatory Surgical
Treatment Center Act; or
2)
Completion of continuing medical education:
A) For conscious sedation only, the physician
shall complete a minimum of 8 hours of continuing medical education (CME)
within each 3 year license renewal period in delivery of anesthesia, including
the administration of conscious sedation. The physician will be required to
complete 4 of the 8 hours of CME by July 31, 2003. The remaining 4 hours of CME
shall be completed by the July 31, 2005 renewal.
B) For deep sedation, regional anesthesia
and/or general anesthesia, a physician shall complete a minimum of 34 hours of
continuing medical education in the delivery of anesthesia services within each
3 year license renewal period. The physician will be required to complete 16 of
the 34 hours of CME by July 31, 2003. The remaining 18 hours of CME shall be
completed by the July 31, 2005 renewal. Fulfillment of this requirement shall
satisfy the requirement of subsection (b)(2)(A) for the administration of
conscious sedation.
C) A continuing
medical education program shall be conducted by a university, professional
association, or hospital as a formal CME program under 68 Ill. Adm. Code
1285.110(b)(2).
c) In a physician's
office where anesthesia services are being administered, all operating
physicians and anesthesiologists shall obtain Advanced Cardiac Life Support
(ACLS) certification by December 31, 2002, and shall maintain current ACLS
certification. If the physician enters into a practice agreement with the CRNA,
the CRNA shall also have a current ACLS certification pursuant to 68 Ill. Adm.
Code
1305.45.
d) The ACLS certification and the physician
training and experience required by this Section shall be documented in the
written practice agreement between the physician and CRNA.
e) The continuing medical education required
in subsection (b) and the ACLS training required in subsection (c) may be
applied to fulfillment of the 150 hours continuing medical education required
for renewal of a license.
f)
Definitions of Anesthesia
1) Moderate
Sedation Analgesia (Conscious Sedation) is 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 usually maintained.
2) Deep Sedation/Analgesia is 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. Patients may
require assistance in maintaining a patent airway and spontaneous ventilation
may be inadequate. Cardiovascular function is usually maintained.
3) Regional Anesthesia is the administration
of local anesthetic agents to a patient to interrupt nerve impulses in a major
region of the body without loss of consciousness and include epidural, caudal,
spinal and brachial plexus anesthesia.
4) General Anesthesia is 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 or drug-induced depression of neuromuscular function.
Cardiovascular function may be impaired.
g) Physicians who perform procedures in an
office setting utilizing anesthesia in the following manner are not required to
comply with this Section:
1) The use of local
anesthesia in which the total dose of local anesthesia does not exceed 50% of
the commonly accepted toxic dose on a weight adjusted basis.
2) The use of topical anesthesia in which the
total dose of topical anesthesia does not exceed 50% of the commonly accepted
toxic dose on a weight adjusted basis.
3) The use of minimal sedation (anxiolysis).
Minimal sedation (anxiolysis) is a drug-induced state during which patients
respond normally to verbal commands. Although cognitive function and
coordination may be impaired, respiratory and cardiovascular functions are
unaffected.
