Current through all regulations passed and filed through September 16, 2024
(A) A physician or
podiatric physician performing special procedures
or surgery in the office setting during which moderate sedation/analgesia is
administered shall:
(1) Demonstrate
sufficient education, training and experience needed to conform to the minimal
standards of care of similar practitioners under the same or similar
circumstances by meeting at least one of the following criteria:
(a) Holding current privileges at a local
hospital accredited by the joint commission on accreditation of healthcare
organizations or the American osteopathic association or at a local ambulatory
surgical facility licensed by the department of health for the
special procedure or surgery being
performed;
(b) Being board
certified by a specialty board recognized by the American board of medical
specialties or the American osteopathic association or, if a podiatric
physician, is board certified by the American board of podiatric surgery; and
the surgery or special procedure being performed
is generally recognized as being within the usual course of practice of that
specialty;
(c) Having successfully
completed a residency training program approved by the accreditation council
for graduate medical education of the American medical association or the
American osteopathic association or, if a podiatric physician, having
successfully completed at least a twelve month residency in podiatric surgery
approved by the council on podiatric medical education; and the surgery or
special procedure being performed is generally
recognized as being within the usual course of practice of that specialty;
or
(d) Having successfully
completed a didactic course supplemented by direct hands-on, monitored
experience in the surgery or procedure being performed, and the surgery or
special procedure being performed is generally
recognized as being within the usual course of practice of the specialty of the
physician.
(2) Have
current (within the immediately previous two years) advanced cardiac life
support/advanced trauma life support training, or, in the case of pediatric
patients under the age of thirteen, have current (within the immediately
previous two years) pediatric advanced life support training.
(3) Ensure that assisting personnel are
competent to administer and monitor moderate sedation/analgesia and to manage
emergencies such as loss of airway, compromise of cardiovascular functions or
anaphylaxis.
(4) A physician or
podiatric physician performing surgeries or special procedures using moderate sedation/analgesia
in the office setting shall:
(a) Hold
privileges to provide moderate sedation/analgesia from a local hospital
accredited by the joint commission on accreditation of healthcare organizations
or the American osteopathic association or from a local ambulatory surgical
facility licensed by the department of health; or
(b) Have documented evidence of having
completed at least five hours of category I continuing medical education
relating to the delivery of moderate sedation/analgesia during the current or
most recent past biennial registration period.
(B) Moderate sedation/analgesia may be
administered in the office setting by only the following:
(1) A physician who holds privileges to
provide moderate sedation/analgesia from a local hospital accredited by the
joint commission on accreditation of healthcare organizations or the American
osteopathic association or from a local ambulatory surgical facility licensed
by the department of health;
(2) A
certified registered nurse anesthetist who is acting under the supervision of
and in the immediate presence of a physician or podiatric physician;
(3) A registered nurse who is acting under
the supervision and in the immediate presence of a physician or podiatric
physician, provided that such registered nurse shall only administer
specifically prescribed doses of drugs selected by the physician or podiatric
physician who shall be continuously present in the anesthetizing location
during the administration of those drugs.
(C) The person administering and monitoring
the moderate sedation/analgesia shall be at all times present in the
anesthetizing location with the patient and cannot be the practitioner while
performing the surgery or procedure. Further, the person administering and
monitoring the moderate sedation/analgesia shall meet the training requirements
of paragraph (A)(2) of this rule.
(D) A violation of any provision of this
rule, as determined by the board, shall constitute "a departure from, or the
failure to conform to, minimal standards of care of similar practitioners under
the same or similar circumstances, whether or not actual injury to a patient is
established," as that clause is used in division (B)(6) of section
4731.22 of the Revised Code.
