(1) Is a licensed dentist in the State of West Virginia;
(2) Holds valid and current documentation showing successful completion of a Health Care Provider BLS/CPR course; and
(3) Has completed a training course of instruction in dental school, continuing education or as a postgraduate in the administration of relative analgesia.
(b) A practitioner who administers relative analgesia shall have the following facilities, equipment and drugs available during the procedure and during recovery:
(1) An operating room large enough to adequately accommodate the patient on an operating table or in an operating chair and to allow delivery of age appropriate care in an emergency situation;
(2) An operating table or chair which permits the patient to be positioned so that the patient's airway can be maintained, quickly alter the patient's position in an emergency, and provide a firm platform for the administration of basic life support;
(3) A lighting system which permits evaluation of the patient's skin and mucosal color and a backup lighting system of sufficient intensity to permit completion of any operation underway in the event of a general power failure;
(4) Suction equipment which permits aspiration of the oral and pharyngeal cavities;
(5) An oxygen delivery system with adequate full face masks and appropriate connectors that is capable of delivering high flow oxygen to the patient under positive pressure, together with an adequate backup system; and
(6) A nitrous oxide delivery system with a fail-safe mechanism that will insure appropriate continuous oxygen delivery and a scavenger system.
All equipment used must be appropriate for the height and weight of the patient.
(c) Before inducing nitrous oxide sedation, a practitioner shall:
(1) Evaluate the patient;
(2) Give instruction to the patient or, when appropriate due to age or psychological status of the patient, the patient's guardian; and
(3) Certify that the patient is an appropriate candidate for relative analgesia.
(d) A practitioner who administers relative analgesia shall see that the patient's condition is visually monitored. At all times the patient shall be observed by a Qualified Monitor until discharge criteria have been met. The Qualified Monitor shall hold valid and current documentation showing successful completion of a Health Care Provider BLS/CPR certification. Documentation of credentials and training must be maintained in the personnel records of the Qualified Monitor. The patient shall be monitored as to response to verbal stimulation and oral mucosal color.
(e) The record must include documentation of all medications administered with dosages, time intervals and route of administration.
(f) A discharge entry shall be made in the patient's record indicating the patient's condition upon discharge.
(g) Hold valid and current documentation:
(1) Showing successful completion of a Health Care Provider BLS/CPR course; and
(2) Have received training and be competent in the recognition and treatment of medical emergencies, monitoring vital signs, the operation of nitrous oxide delivery systems and the use of the sphygmomanometer and stethoscope.
(h) The practitioner shall assess the patient's responsiveness using preoperative values as normal guidelines and discharge the patient only when the following criteria are met:
(1) The patient is alert and oriented to person, place and time as appropriate to age and preoperative neurological status;
(2) The patient can talk and respond coherently to verbal questioning or to preoperative neurological status;
(3) The patient can sit up unaided or without assistance or to preoperative neurological status;
(4) The patient can ambulate with minimal assistance or to preoperative neurological status; and
(5) The patient does not have nausea, vomiting or dizziness. Note: WV Code updated with legislation passed through the 2012 1st Special Session
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