Texas Register, Volume 30, Number 43, Pages 6973-7094, October 28, 2005 Page: 7,045
This periodical is part of the collection entitled: Texas Register and was provided to The Portal to Texas History by the UNT Libraries Government Documents Department.
Extracted Text
The following text was automatically extracted from the image on this page using optical character recognition software:
(C) Regional anesthesia--injection of an anesthetic
agent to the nerves supplying a region of the body that results in a loss
of sensation.
(D) Minimal sedation (anxiolysis)--a drug-induced
state during which patients respond normally to verbal commands.
Although cognitive function and coordination may be impaired,
ventilatory and cardiovascular functions are unaffected.
(E) Moderate sedation/analgesia ("conscious seda-
tion")--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 (reflex withdrawal from
a painful stimulus is NOT considered a purposeful response).
(F) Deep sedation/analgesia--a drug-induced depres-
sion 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 air-
way, and spontaneous ventilation may be inadequate. Cardiovascular
function is usually maintained. (Reflex withdrawal from a painful
stimulus is NOT considered a purposeful response.)
(G) General anesthesia--a drug-induced loss of con-
sciousness 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 de-
pression of neuromuscular function. Cardiovascular function may be
impaired.
(2) The anesthesia department shall be under the medical
direction of a physician approved by the governing body upon the rec-
ommendation of the ASC medical staff.
(3) The medical staff shall develop written policies and
practice guidelines for the anesthesia service, which shall be approved,
implemented and enforced by the governing body. The policies and
guidelines must include consideration of the applicable practice stan-
dards and guidelines of the American Society of Anesthesiologists, the
American Association of Nurse Anesthetists, and the licensing rules
and standards applicable to those categories of licensed professionals
qualified to administer anesthesia.
(4) Administration of anesthesia or sedation.
(A) The following practitioners may administer all cat-
egories of anesthesia and sedation, in accordance with their education
and training:
(i) an anesthesiologist;
(ii) a physician, dentist, oral surgeon or podiatrist
who is qualified under state law and has education, training and ex-
perience in the type of anesthesia being performed; and
(iii) a certified registered nurse anesthetist practic-
ing in accordance with the Nursing Practice Act and the rules and reg-
ulations promulgated by the Board of Nurse Examiners.
(B) A qualified registered nurse (RN) who is not a certi-
fied registered nurse anesthetist (CRNA), in accordance with the orders
of the operating surgeon or an anesthesiologist, may administer topical
anesthesia, local anesthesia, minimal sedation and moderate sedation,
in accordance with all applicable rules, polices, directives and guide-
lines issued by the Board of Nurse Examiners for the State of Texas.When an RN who is not a CRNA administers sedation, as permitted in
this paragraph, the facility must:
(i) verify that the registered nurse has the requisite
training, education and experience;
(ii) maintain documentation to support that the reg-
istered nurse has demonstrated competency in the administration of se-
dation;
(iii) with input from the facility's qualified anesthe-
sia providers, develop, implement and enforce detailed, written policies
and procedures to guide the registered nurse; and
(iv) ensure that, when administering sedation during
a procedure, the registered nurse has no other duties except to monitor
the patient.
(5) Anesthesia shall not be administered unless the operat-
ing surgeon or anesthesiologist has evaluated the patient immediately
prior to surgery to assess the risk of the anesthesia relative to the surgi-
cal procedure to be performed.
(6) The anesthesiologist or the operating surgeon shall be
available until all of his or her patients operated on that day have been
discharged from the post-anesthesia care unit.
(7) Patients who have received anesthesia shall be evalu-
ated for proper anesthesia recovery by the operating surgeon or the per-
son administering the anesthesia prior to discharge from the post-anes-
thesia care unit using criteria approved by the medical staff.
(8) Patients who remain in the facility for extended obser-
vation following discharge from the post-anesthesia care unit shall be
evaluated immediately prior to leaving the facility by a physician, the
person administering the anesthesia or a registered nurse acting in ac-
cordance with physician's orders and written policies, procedures and
criteria developed by the medical staff.
(9) A physician shall be on call and able to respond phys-
ically or by telephone within 30 minutes until all patients have been
discharged from the ASC.
(10) Emergency equipment and supplies appropriate for
the type of anesthesia services provided shall be maintained and
accessible to staff at all times.
(A) Functioning equipment and supplies which are re-
quired for all facilities include:
(i) suctioning equipment, including a source of suc-
tion and suction catheters in appropriate sizes for the population being
served;
(ii) source of compressed oxygen;
(iii) basic airway management equipment, including
oral and nasal airways, face masks, and self-inflating breathing bag-
valve set;
(iv) blood pressure monitoring equipment; and
(v) emergency medications specified by the medical
staff and appropriate to the type of surgical procedures and anesthesia
services provided by the facility.
(B) In addition to the equipment and supplies required
under subparagraph (A) of this paragraph, facilities which provide
moderate sedation/analgesia, deep sedation/analgesia, regional anal-
gesia and/or general anesthesia must provide the following:ADOPTED RULES October 28, 2005 30 TexReg 7045
Upcoming Pages
Here’s what’s next.
Search Inside
This issue can be searched. Note: Results may vary based on the legibility of text within the document.
Tools / Downloads
Get a copy of this page or view the extracted text.
Citing and Sharing
Basic information for referencing this web page. We also provide extended guidance on usage rights, references, copying or embedding.
Reference the current page of this Periodical.
Texas. Secretary of State. Texas Register, Volume 30, Number 43, Pages 6973-7094, October 28, 2005, periodical, October 28, 2005; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth97316/m1/71/?rotate=270: accessed July 16, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.