Home Table of Contents

§ 1043.3. Onsite Inspections.


Barclays Official California Code of Regulations Currentness
Title 16. Professional and Vocational Regulations
Division 10. Dental Board of California
Chapter 2. Dentists
Article 5. General Anesthesia and (Moderate) Conscious Sedation
16 CCR § 1043.3
§ 1043.3. Onsite Inspections.
All offices in which general anesthesia or conscious sedation is conducted under the terms of this article shall, unless otherwise indicated, meet the standards set forth below. In addition, an office may in the discretion of the board be required to undergo an onsite inspection. For the applicant who administers in both an outpatient setting and at an accredited facility, the onsite must be conducted in an outpatient setting. The evaluation of an office shall consist of three parts:
(a) Office Facilities and Equipment. The following office facilities and equipment shall be available and shall be maintained in good operating condition:
(1) An operating theatre large enough to adequately accommodate the patient on a table or in an operating chair and permit an operating team consisting of at least three individuals to freely move about the patient.
(2) An operating table or chair which permits the patient to be positioned so the operating team can maintain the airway, quickly alter patient position in an emergency, and provide a firm platform for the management of cardiopulmonary resuscitation.
(3) A lighting system which is adequate to permit evaluation of the patient's skin and mucosal color and a backup lighting system which is battery powered and of sufficient intensity to permit completion of any operation underway at the time of general power failure.
(4) Suction equipment which permits aspiration of the oral and pharyngeal cavities. A backup suction device which can operate at the time of general power failure must also be available.
(5) An oxygen delivery system with adequate full face masks and appropriate connectors that is capable of allowing the administering of greater than 90% oxygen at a 10 liter/minute flow at least sixty minutes (650 liter “E” cylinder) to the patient under positive pressure, together with an adequate backup system which can operate at the time of general power failure.
(6) A recovery area that has available oxygen, adequate lighting, suction, and electrical outlets. The recovery area can be the operating theatre.
(7) Ancillary equipment:
(A) Laryngoscope complete with adequate selection of blades and spare batteries and bulb. (This equipment is not required for conscious sedation.)
(B) Endotracheal tubes and appropriate connectors. (This equipment is not required for conscious sedation.)
(C) Emergency airway equipment (oral airways, laryngeal mask airways or combitubes, cricothyrotomy device).
(D) Tonsillar or pharyngeal type suction tip adaptable to all office outlets.
(E) Endotracheal tube forcep. (This equipment is not required for conscious sedation.)
(F) Sphygmomanometer and stethoscope.
(G) Electrocardioscope and defibrillator. (This equipment is not required for conscious sedation.)
(H) Adequate equipment for the establishment of an intravenous infusion.
(I) Precordial/pretracheal stethoscope.
(J) Pulse oximeter.
(K) Capnograph and temperature device. A capnograph and temperature measuring device are required for the intubated patient receiving general anesthesia. (This equipment is not required for conscious sedation.)
(b) Records. The following records shall be maintained:
(1) Adequate medical history and physical evaluation records updated prior to each administration of general anesthesia or conscious sedation. Such records shall include, but are not limited to the recording of the age, sex, weight, physical status (American Society of Anesthesiologists Classification), medication use, any known or suspected medically compromising conditions, rationale for sedation of the patient, and visual examination of the airway, and for general anesthesia only, auscultation of the heart and lungs as medically required.
(2) General Anesthesia and/or conscious sedation records, which shall include a time-oriented record with preoperative, multiple interaoperative, and postoperative pulse oximetry (every 5 minutes intraoperatively and every 15 minutes postoperatively for general anesthesia) and blood pressure and pulse readings, (both every 5 minutes intraoperatively for general anesthesia) drugs, amounts administered and time administered, length of the procedure, any complications of anesthesia or sedation and a statement of the patient's condition at time of discharge.
(3) Written informed consent of the patient or if the patient is a minor, his or her parent or guardian.
(c) Drugs. Emergency drugs of the following types shall be available:
(1) Epinephrine
(2) Vasopressor (other than epinephrine)
(3) Bronchodilator
(4) Muscle relaxant (This is not required for conscious sedation.)
(5) Intravenous medication for treatment of cardiopulmonary arrest (This is not required for conscious sedation.)
(6) Appropriate drug antagonist
(7) Antihistaminic
(8) Anticholinergic
(9) Antiarrhythmic (This is not required for conscious sedation.)
(10) Coronary artery vasodilator
(11) Antihypertensive (This is not required for conscious sedation.)
(12) Anticonvulsant
(13) Oxygen
(14) 50% dextrose or other antihypoglycemic
(d) Prior to an onsite inspection and evaluation, the dentist shall provide a complete list of his/her emergency medications to the evaluator.
Note: Authority cited: Section 1614, Business and Professions Code. Reference: Sections 1646.2, 1646.3, 1647.3 and 1647.6, Business and Professions Code.
1. Amendment filed 4-1-91; operative 5-1-91 (Register 91, No. 18).
2. Editorial correction of subsection (a)(4) (Register 95, No. 16).
3. Amendment filed 2-27-2006; operative 3-29-2006 (Register 2006, No. 9).
This database is current through 12/31/21 Register 2021, No. 53
16 CCR § 1043.3, 16 CA ADC § 1043.3
End of Document