Ohio Administrative Code|Rule 4731-25-03 | Standards for surgery using moderate sedation/analgesia.

                                                
(A) A physician or podiatric physician
		  performing special procedures or surgery in the office setting during which
		  moderate sedation/analgesia is administered shall:
(1) Demonstrate
			 sufficient education, training and experience needed to conform to the minimal
			 standards of care of similar practitioners under the same or similar
			 circumstances by meeting at least one of the following criteria:
(a) Holding current privileges at a local hospital
				accredited by the joint commission on accreditation of healthcare organizations
				or the American osteopathic association or at a local ambulatory surgical
				facility licensed by the department of health for the special procedure or
				surgery being performed;
(b) Being board certified by a specialty board recognized
				by the American board of medical specialties or the American osteopathic
				association or, if a podiatric physician, is board certified by the American
				board of podiatric surgery; and the surgery or special procedure being
				performed is generally recognized as being within the usual course of practice
				of that specialty;
(c) Having successfully completed a residency training
				program approved by the accreditation council for graduate medical education of
				the American medical association or the American osteopathic association or, if
				a podiatric physician, having successfully completed at least a twelve month
				residency in podiatric surgery approved by the council on podiatric medical
				education; and the surgery or special procedure being performed is generally
				recognized as being within the usual course of practice of that specialty;
				or
(d) Having successfully completed a didactic course
				supplemented by direct hands-on, monitored experience in the surgery or
				procedure being performed, and the surgery or special procedure being performed
				is generally recognized as being within the usual course of practice of the
				specialty of the physician.
(2) Have current (within
			 the immediately previous two years) advanced cardiac life support/advanced
			 trauma life support training, or, in the case of pediatric patients under the
			 age of thirteen, have current (within the immediately previous two years)
			 pediatric advanced life support training.
(3)  Ensure that
			 assisting personnel are competent to administer and monitor moderate
			 sedation/analgesia and to manage emergencies such as loss of airway, compromise
			 of cardiovascular functions or anaphylaxis.
(4) A physician or
			 podiatric physician performing surgeries or special procedures using moderate
			 sedation/analgesia in the office setting shall:
(a) Hold privileges to provide moderate sedation/analgesia
				from a local hospital accredited by the joint commission on accreditation of
				healthcare organizations or the American osteopathic association or from a
				local ambulatory surgical facility licensed by the department of health;
				or
(b) Have documented evidence of having completed at least
				five hours of category I continuing medical education relating to the delivery
				of moderate sedation/analgesia during the current or most recent past biennial
				registration period.
(B) Moderate sedation/analgesia may be
		  administered in the office setting by only the following:
(1) A physician who holds
			 privileges to provide moderate sedation/analgesia from a local hospital
			 accredited by the joint commission on accreditation of healthcare organizations
			 or the American osteopathic association or from a local ambulatory surgical
			 facility licensed by the department of health;
(2) A certified
			 registered nurse anesthetist who is acting under the supervision of and in the
			 immediate presence of a physician or podiatric physician;
(3) A registered nurse
			 who is acting under the supervision and in the immediate presence of a
			 physician or podiatric physician, provided that such registered nurse shall
			 only administer specifically prescribed doses of drugs selected by the
			 physician or podiatric physician who shall be continuously present in the
			 anesthetizing location during the administration of those drugs.
(C) The person administering and
		  monitoring the moderate sedation/analgesia shall be at all times present in the
		  anesthetizing location with the patient and cannot be the practitioner while
		  performing the surgery or procedure. Further, the person administering and
		  monitoring the moderate sedation/analgesia shall meet the training requirements
		  of paragraph (A)(2) of this rule.
(D) A violation of any provision of this
		  rule, as determined by the board, shall constitute "a departure from, or
		  the failure to conform to, minimal standards of care of similar practitioners
		  under the same or similar circumstances, whether or not actual injury to a
		  patient is established," as that clause is used in division (B)(6) of
		  section 4731.22 of the Revised Code.