034-5 Wyo. Code R. §§ 5-6 - Requirements for Administering Moderate Sedation, Deep Sedation, and/or General Anesthesia

(a) A sedation permit shall be required for a sedation permit holder to administer moderate sedation, deep sedation, and/or general anesthesia.

(b) Office Equipment Requirements.

(i) Any sedation permit holder who administers moderate sedation, deep sedation, and/or general anesthesia shall have available the required equipment in Section 5(d) and the following additional equipment and faculties, which shall be functional and available at all times:

(A) Suitable operating suite;

(B) Recovery area;

(C) Gas storage facilities with back up tanks and mobile back-up oxygen, which generally meet accepted safety standards;

(D) Suction system;

(E) Back-up suction equipment;

(F) Back-up lighting equipment;

(G) Parenteral access or the ability to gain parenteral access, if clinically indicated;

(H) Capnograph (end tidal carbon dioxide monitor);

(I) EKG;

(J) Appropriate emergency medications;

(K) Endotracheal tubes suitable for patients being treated;

(L) Endotracheal tube forceps (i.e., magill);

(M) A laryngoscope with reserve batteries and bulbs;

(N) Oropharyngeal airways;

(O) Nasopharyngeal airways; and

(P) At least one (1) additional airway device.

(ii) Volatile Anesthesia Delivery Systems. Any sedation permit holder who administers volatile anesthesia shall provide the required equipment listed in Section 5(d) and Section 6(b)(i) and the following additional equipment and facilities, which shall be functional and available at all times:

(A) Capability to deliver oxygen to a patient under positive pressure, including a back-up oxygen system;

(B) Gas outlets that meet generally accepted safety standards preventing accidental administration of inappropriate gases or gas mixture;

(C) Fail-safe mechanisms for inhalation of nitrous oxide anxiolysis;

(D) The inhalation equipment must have an appropriate scavenging system if volatile anesthetics are used; and

(E) Gas storage facilities, which meet generally accepted safety standards.

(c) A sedation permit holder shall document every administration of moderate sedation, deep sedation, and/or general anesthesia. Documentation for administration of moderate sedation, deep sedation, and/or general anesthesia shall include the required documents listed in Section 5(e) and the following additional documentation:

(i) Current and comprehensive medical history, including:

(A) Medical conditions; and

(B) Age;

(ii) Physical examination, including:

(A) Airway assessment;

(B) Respiratory rate; and

(C) Temperature;

(iii) ASA Classification;

(iv) Procedure(s);

(v) Informed Consent;

(vi) Anesthesia Record, which shall include:

(A) Vital signs before and after anesthesia is utilized;

(B) Parenteral access site and method, if utilized;

(C) Medication(s) administered;

(D) Time anesthesia commenced and ended;

(E) Monitor blood pressure, heart rate, and oxygen saturation at least every five (5) minutes;

(F) EKG;

(G) Capnograph (end tidal carbon dioxide monitor);

(H) Ventilation status (spontaneous, assisted, or controlled);

(I) Intravenous fluids, if utilized;

(J) Response to anesthesia, including any complications;

(K) Starting time of recovery and time of discharge; and

(L) Condition of patient at discharge and authorization of sedation permit holder.

(d) All dental personnel shall be certified in administering BLS. A dentist or sedation permit holder may delegate patient monitoring to qualified dental personnel.

(i) Moderate Sedation. During a procedure where moderate sedation is administered, the sedation permit holder and at least one (1) other dental personnel shall be present.

(ii) Deep Sedation and/or General Anesthesia. During a procedure where deep sedation and/or general anesthesia is administered, the sedation permit holder and at least two (2) other dental personnel shall be present and at least one (1) shall be experienced in patient monitoring and documentation.

(e) A dentist or sedation permit holder shall be subject to disciplinary action if:

(i) A dentist administers moderate sedation, deep sedation, and/or general anesthesia without a sedation permit; or

(iii) A permit holder administers deep sedation and/or general anesthesia with a sedation permit for moderate sedation.

Notes

034-5 Wyo. Code R. §§ 5-6

Amended, Eff. 1/8/2015. Amended, Eff. 9/26/2017. Amended, Eff. 1/14/2022. Amended, Eff. 5/29/2024.