Anesthesia & AED
DQAC has determined that anesthesia permitting should be based on the "level" of anesthesia because anesthesia / sedation is a continuum, and the route of administration and drug combinations are both capable of producing a deeper level of sedation / anesthesia than is initially intended. Practitioners intending to produce a given level of sedation should be able to rescue patients who enter a state deeper than initially intended.
Effective December 10th, 2010:
DQAC has modified the rules requiring automated external defibrillators (AEDs) in dental offices by adopting changes requested by WSDA.
- All anesthesia providers must provide twenty-four hour, on-call availability following an anesthesia procedure, excluding those procedures using only local anesthetic.
- Every dental office in the state of Washington that administers minimal, moderate, or deep sedation, or general anesthesia, as defined in WAC 246-817-710, must have an automated external defibrillator (AED) or defibrillator.
- The dentist and staff must have access to the AED or defibrillator in an emergency, and it must be available and in reach within sixty seconds.
- A dental office may share a single AED or defibrillator with adjacent businesses if it meets the requirements in this section.
Anesthesia Training Requirements
In order to administer minimal sedation in Washington, a dentist must complete two training requirements: a one-time course (14 or 21 hours depending on method of minimal sedation) and continuing education (seven hours every five years). Dentists likely completed the one time course requirement while in dental school. Each dentist is responsible to determine if they have completed both training requirements.
Initial Minimal Sedation Course
To administer minimal sedation a dentist must complete a course in either dental school or postgraduate instruction. The length of course required depends upon the method of minimal sedation (WAC 246-817-740, WAC 246-817-745):
To administer nitrous oxide or minimal sedation with a single oral agent, a dentist must have completed a course (in either dental school or postgraduate instruction) containing a minimum of 14 hours.
In order to administer any oral agent in combination with a different agent or multiple agents other than nitrous oxide a dentist must have completed a course (in either dental school or postgraduate instruction) containing a minimum of 21 hours.
Ongoing Continuing Education Requirements
In addition to the 14 or 21 hour training requirement stated above, a dentist must participate in seven hours of continuing education every five years. The continuing education must include instruction in one or more of the following areas: sedation physiology, pharmacology, inhalation analgesia, patient evaluation, patient monitoring, or medical emergencies. (WAC 246-817-740, WAC 246-817-745)