Florida Regulations 64B5-14.0032: Itinerate/Mobile Anesthesia – Physician Anesthesiologist
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The provisions of this rule control the treatment of dental patients in an outpatient dental office setting where a physician anesthesiologist has performed the sedation services. This rule shall control notwithstanding any rule provision in this chapter that prohibits such conduct. The level of sedation is not restricted to the level of the permit held by the treating dentist. The level of sedation may be any level necessary for the safe and effective treatment of the patient.
(1) General Anesthesia Permit Holders:
A dentist who holds a general anesthesia permit may treat their adult, pediatric, or special needs patients when a physician anesthesiologist performs the sedation services. The following conditions shall apply:
(a) The physician anesthesiologist performs the administration of the anesthesia and the physician anesthesiologist is responsible for the anesthesia procedure;
(b) A physician anesthesiologist shall only have one patient at a time induced. A second patient shall not be induced until the first patient has been discharged out of the dental office or is arousable, spontaneously breathing, has stable vital signs and is under the care of a licensee or assistant that is trained in anesthesia recovery;
(c) The dental treatment takes place in the general anesthesia permit holder’s dental office that is on file with the board as an authorized location to perform sedation services and that has been inspected pursuant to Fl. Admin. Code R. 64B5-14.007
(2) Pediatric Moderate Sedation Permit Holders:
A pediatric dentist, as recognized by the American Dental Association, who holds a pediatric Moderate sedation permit may treat their pediatric or special needs dental patients when a physician anesthesiologist performs the sedation services. The following conditions shall apply:
(a) The physician anesthesiologist performs the administration of the anesthesia, and the physician anesthesiologist is responsible for the anesthesia procedure;
(b) A physician anesthesiologist shall only have one patient at a time induced. A second patient shall not be induced until the first patient has been discharged out of the dental office or is arousable, spontaneously breathing, has stable vital signs and is under the care of a licensee or assistant that is trained in anesthesia recovery;
(c) The treatment takes place in the permit holder’s dental office that is on file with the board as an authorized location to perform sedation services and that has been inspected pursuant to Fl. Admin. Code R. 64B5-14.007
(d) The dental office meets the supply, equipment, and facility requirements as mandated in Fl. Admin. Code R. 64B5-14.008;
(e) A board-approved inspector performs an additional inspection of the dental office and the inspector reports the office to be in full compliance with the minimum supply, equipment, and facility requirements.
(3) Moderate Sedation Permit Holders:
A dentist who holds a moderate sedation permit may treat their adult or adult special needs dental patients when a physician anesthesiologist performs the sedation services. The following conditions shall apply:
(a) The physician anesthesiologist performs the administration of the anesthesia, and the physician anesthesiologist is responsible for the anesthesia procedure;
(b) A physician anesthesiologist shall only have one patient at a time induced. A second patient shall not be induced until the first patient has been discharged out of the dental office or is arousable, spontaneously breathing, has stable vital signs and is under the care of a licensee or assistant that is trained in anesthesia recovery;
(c) The treatment takes place in the permit holder’s dental office that is on file with the board as an authorized location to perform sedation services and that has been inspected pursuant to Fl. Admin. Code R. 64B5-14.007
(d) The dental office meets the supply, equipment, and facility requirements as mandated in Fl. Admin. Code R. 64B5-14.008;
(e) A board-approved inspector performs an additional inspection of the dental office and the inspector reports the office to be in full compliance with the minimum supply, equipment, and facility requirements.
(4) Non-Sedation Permit Holders:
All provisions of this Chapter relating to the administration of any type of anesthesia or sedation and treatment to sedated patients shall remain in full force and effect. Nothing in this section supersedes, alters, or creates a variance to any prohibitions and mandates applicable to non-sedation permit holding dentists.
(5) Staff or Assistants:
A dentist treating a patient pursuant to this rule must have at least three (3) properly credentialed individuals present as mandated in Fl. Admin. Code R. 64B5-14.003 To fulfill the mandatory minimum required personnel requirements of Fl. Admin. Code R. 64B5-14.003, an anesthesiologist assistant licensed pursuant to Section 458.3475, or 459.023, F.S., or a certified registered nurse anesthetist, in addition to or in lieu of a dental assistant or dental hygienist, may be utilized. However, the dentist must have a dedicated member of the team to assist in the dental procedure or during emergencies.
(6) Equipment:
A dentist may comply with the electrocardiograph equipment requirements set by Fl. Admin. Code R. 64B5-14.008, by utilizing the physician’s mobile or non-fixed equipment if the dentist meets the following conditions:
(a) During the required board inspection, the equipment is available for inspection, or the dentist supplies an inspection of the equipment, which a health care risk manager performed. A health care risk manager inspection is valid for a period of twelve months; and,
(b) The dentist shall make the inspected equipment available during all required inspections, if specifically requested within 48 hours in advance of the inspection, and the equipment must be immediately available for an adverse incident inspection.
(c) As long as the permit holder’s dental office meets the supply, equipment, and facility requirements as mandated in Fl. Admin. Code R. 64B5-14.008, nothing in this rule shall be interpreted to prevent a physician anesthesiologist from utilizing their non-fixed mobile equipment when providing anesthesia services in the permit holder’s dental office.
(7) Records:
The treating dentist shall maintain a complete copy of the anesthesia records in the patient’s dental chart. The dentist shall make certain that name and license numbers identify the treating dentist, the physician anesthesiologist, and all personnel utilized during the procedure.
Rulemaking Authority Florida Statutes § 466.004(4), 466.017(3) FS. Law Implemented 466.017(3) FS. History-New 8-20-12, Amended 11-19-12, 2-21-13, 12-16-13, 11-13-17, 3-10-20.
(1) General Anesthesia Permit Holders:
A dentist who holds a general anesthesia permit may treat their adult, pediatric, or special needs patients when a physician anesthesiologist performs the sedation services. The following conditions shall apply:
(a) The physician anesthesiologist performs the administration of the anesthesia and the physician anesthesiologist is responsible for the anesthesia procedure;
(b) A physician anesthesiologist shall only have one patient at a time induced. A second patient shall not be induced until the first patient has been discharged out of the dental office or is arousable, spontaneously breathing, has stable vital signs and is under the care of a licensee or assistant that is trained in anesthesia recovery;
(c) The dental treatment takes place in the general anesthesia permit holder’s dental office that is on file with the board as an authorized location to perform sedation services and that has been inspected pursuant to Fl. Admin. Code R. 64B5-14.007
(2) Pediatric Moderate Sedation Permit Holders:
A pediatric dentist, as recognized by the American Dental Association, who holds a pediatric Moderate sedation permit may treat their pediatric or special needs dental patients when a physician anesthesiologist performs the sedation services. The following conditions shall apply:
(a) The physician anesthesiologist performs the administration of the anesthesia, and the physician anesthesiologist is responsible for the anesthesia procedure;
(b) A physician anesthesiologist shall only have one patient at a time induced. A second patient shall not be induced until the first patient has been discharged out of the dental office or is arousable, spontaneously breathing, has stable vital signs and is under the care of a licensee or assistant that is trained in anesthesia recovery;
(c) The treatment takes place in the permit holder’s dental office that is on file with the board as an authorized location to perform sedation services and that has been inspected pursuant to Fl. Admin. Code R. 64B5-14.007
(d) The dental office meets the supply, equipment, and facility requirements as mandated in Fl. Admin. Code R. 64B5-14.008;
(e) A board-approved inspector performs an additional inspection of the dental office and the inspector reports the office to be in full compliance with the minimum supply, equipment, and facility requirements.
(3) Moderate Sedation Permit Holders:
A dentist who holds a moderate sedation permit may treat their adult or adult special needs dental patients when a physician anesthesiologist performs the sedation services. The following conditions shall apply:
(a) The physician anesthesiologist performs the administration of the anesthesia, and the physician anesthesiologist is responsible for the anesthesia procedure;
(b) A physician anesthesiologist shall only have one patient at a time induced. A second patient shall not be induced until the first patient has been discharged out of the dental office or is arousable, spontaneously breathing, has stable vital signs and is under the care of a licensee or assistant that is trained in anesthesia recovery;
(c) The treatment takes place in the permit holder’s dental office that is on file with the board as an authorized location to perform sedation services and that has been inspected pursuant to Fl. Admin. Code R. 64B5-14.007
(d) The dental office meets the supply, equipment, and facility requirements as mandated in Fl. Admin. Code R. 64B5-14.008;
(e) A board-approved inspector performs an additional inspection of the dental office and the inspector reports the office to be in full compliance with the minimum supply, equipment, and facility requirements.
(4) Non-Sedation Permit Holders:
All provisions of this Chapter relating to the administration of any type of anesthesia or sedation and treatment to sedated patients shall remain in full force and effect. Nothing in this section supersedes, alters, or creates a variance to any prohibitions and mandates applicable to non-sedation permit holding dentists.
(5) Staff or Assistants:
A dentist treating a patient pursuant to this rule must have at least three (3) properly credentialed individuals present as mandated in Fl. Admin. Code R. 64B5-14.003 To fulfill the mandatory minimum required personnel requirements of Fl. Admin. Code R. 64B5-14.003, an anesthesiologist assistant licensed pursuant to Section 458.3475, or 459.023, F.S., or a certified registered nurse anesthetist, in addition to or in lieu of a dental assistant or dental hygienist, may be utilized. However, the dentist must have a dedicated member of the team to assist in the dental procedure or during emergencies.
(6) Equipment:
A dentist may comply with the electrocardiograph equipment requirements set by Fl. Admin. Code R. 64B5-14.008, by utilizing the physician’s mobile or non-fixed equipment if the dentist meets the following conditions:
(a) During the required board inspection, the equipment is available for inspection, or the dentist supplies an inspection of the equipment, which a health care risk manager performed. A health care risk manager inspection is valid for a period of twelve months; and,
(b) The dentist shall make the inspected equipment available during all required inspections, if specifically requested within 48 hours in advance of the inspection, and the equipment must be immediately available for an adverse incident inspection.
(c) As long as the permit holder’s dental office meets the supply, equipment, and facility requirements as mandated in Fl. Admin. Code R. 64B5-14.008, nothing in this rule shall be interpreted to prevent a physician anesthesiologist from utilizing their non-fixed mobile equipment when providing anesthesia services in the permit holder’s dental office.
(7) Records:
The treating dentist shall maintain a complete copy of the anesthesia records in the patient’s dental chart. The dentist shall make certain that name and license numbers identify the treating dentist, the physician anesthesiologist, and all personnel utilized during the procedure.
Rulemaking Authority Florida Statutes § 466.004(4), 466.017(3) FS. Law Implemented 466.017(3) FS. History-New 8-20-12, Amended 11-19-12, 2-21-13, 12-16-13, 11-13-17, 3-10-20.