AED REQUIREMENT
201 KAR 8:550, only dentists who perform general anesthesia/deep sedation and moderate sedation would be required to have an automated external defibrillator in their office.
General Dentists and Minimal Sedation permit holders would not be required to have an AED.
*******************************
General Anesthesia/Deep Sedation - A drug-induced depression 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 airway and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.
Moderate Sedation - Is defined as 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.
Minimal Sedation - A drug-induced state during which patients respond normally to commands. Although cognitive function and coordination may be impaired, ventilation and cardiovascular functions are unaffected.
Related:
Medical CE – Self Study Module on Anesthesia
PULSE OXIMETRY IS THE STANDARD OF CARE:
1. PaO2 is the partial pressure of oxygen in the blood
SaO2 of 100% = a PaO2 of 150
SaO2 of 90% = a PaO2 of 60 = WARNING
SaO2 of 75% = a PaO2 of 40 = DANGER
2. Normal PaO2 is between 80 –100 mmHg.
3. The accuracy of the pulse oximetry readings is affected by ambient light,
movement of the patient, skin pigment, some nail polish, IV dye, hypothermia,
anemia and or a low cardiac output.
For a hospital the below is the acceptable standard of care, why not a dental office delivering moderate sedation?
THE FOLLOWING EQUIPMENT SHOULD BE AVAILABLE IN THE
IMMEDIATE AREA WHERE MODERATE SEDATION IS ADMINISTERED
AND WHERE THE PATIENT RECOVERS FROM SEDATION:
2. Oxygen and pulse oximeter
3. Suction
4. Ambu bag and mask
5. Oral, nasopharyngeal airways, endotracheal tubes in various sizes, and stylets
6. Laryngoscopes and various laryngoscope blades
7. EKG
8. Blood pressure monitoring apparatus
9. Adequate lighting
10. Emergency communications system(s)
LEGAL ISSUES
1. Common causes of liability
a. Failure to monitor
b. Errors in the use of equipment
c. Failure to communicate adverse reactions
d. Failure to follow policy and procedure
