Sec.20-123b-9. Office equipment, emergency drugs, and anesthesia records

(a) Except as specifically noted, all practitioners who are being evaluated pursuant to Sections 20-123b-1 through 20-123b-9, inclusive, of the Regulations of Connecticut State Agencies, or who have been issued a permit pursuant to Section 20-123b of the Connecticut General Statutes, shall demonstrate and maintain the following office equipment in any and all offices where they administer general anesthesia or conscious sedation:

(1) Portable gas delivery system capable of positive pressure ventilation;

(2) Equipment capable of administering 100% oxygen in all rooms (operatory, recovery, examination, and reception);

(3) Portable bag-mask ventilator (ambu-bag);

(4) Full face mask:

(A) adult; and

(B) pediatric;

(5) Nasal hood or cannula;

(6) Oral airways (oropharyngeal airways):

(A) adult; and

(B) pediatric;

(7) Nasopharyngeal airways:

(A) adult; and

(B) pediatric;

(8) Endotracheal tubes with appropriate connectors and syringe for inflation, as follows: (not required for conscious sedation permit)

(A) adult endotracheal tubes;

(B) child endotracheal tubes;

(C) connectors;

(D) syringe; and

(E) stylet (pediatric and adult);

(9) Laryngoscope (straight or curved blade), as follows: (not required for conscious sedation permit)

(A) adult blade;

(B) pediatric blade;

(C) extra batteries; and

(D) extra bulb (or blade if fiberoptic blade);

(10) Combi tube (not required for general anesthesia permit);

(11) Portable suctioning equipment capable of use during electrical power failure;

(12) Equipment capable of suctioning the throat in all rooms;

(13) Nasopharyngeal suction catheter, for pulmonary lavage via endotracheal tube (not required for conscious sedation permit);

(14) Yankauer or similar suction;

(15) McGill forceps;

(16) Tongue grasping forceps;

(17) Equipment for emergency crico-thyrotomy or tracheotomy and the appropriate connectors for administering 100% oxygen;

(18) Blood pressure cuffs:

(A) adult; and

(B) pediatric;

(19) ECG;

(20) Defibrillator;

(21) Board or rigid surface for cardiopulmonary resuscitation (CPR);

(22) Light source capable of use during electrical power failure;

(23) Intravenous solutions and equipment for administration:

(A) 250 cc bags & 1000 cc bags of sterile saline; and

(B) Sterile water for mixing or dilution of drugs; and

(24) Appropriate intravenous needles, tubing and drips.

(b) Except as specifically noted, all practitioners who are being evaluated pursuant to sections 20-123b-1 to 20-123b-9, inclusive, of the Regulations of Connecticut State Agencies, or who have been issued a permit pursuant to Section 20-123b of the Connecticut General Statutes, shall demonstrate and maintain the following equipment and personnel for continuous monitoring during the administration of anesthesia in any and all offices where they administer general anesthesia or conscious sedation:

(1) Equipment and personnel for continuous monitoring during the administration of deep sedation or general anesthesia:

(A) means of monitoring heart rate:

(i) ECG;

(ii) pulsemeter;

(iii) pretracheal or precordial stethoscope; or

(iv) direct palpation of pulse;

(B) means of following respirations and level of oxygenation:

(i) pretracheal or precordial stethoscope, or capnography; and

(ii) pulse oximeter;

(C) means of monitoring blood pressure for child and adult.

(2) Equipment and personnel for continuous monitoring during the administration of conscious sedation:

(A) means of monitoring heart rate:

(i) ECG;

(ii) pulsemeter;

(iii) pretracheal or precordial stethoscope; or

(iv) direct palpation of pulse;

(B) means of following respirations and level of oxygenation:

(i) pretracheal or precordial stethoscope, capnography or direct observation of chest; and

(ii) pulse oximeter;

(C) means of monitoring blood pressure for child and adult.

(c) All practitioners who are being evaluated pursuant to Sections 20-123b-1 through 20-123b-9, inclusive, of the Regulations of Connecticut State Agencies, or who have been issued a permit pursuant to Section 20-123b of the Connecticut General Statutes, shall maintain the following emergency drugs in any and all offices where they administer general anesthesia or conscious sedation:

(1) anticonvulsant drugs:

(A) midazolam; or

(B) diazepam;

(2) antiemetic:

(A) droperidol;

(B) odansetron;

(C) prochlorperazine;

(D) promethazine; or

(E) metoclopramide;

(3) beta agonist: albuterol inhaler;

(4) cardiovascular medications:

(A) antiarrhythmics:

(i) lidocaine or amiodarone;

(ii) procainamide; and

(iii) diltiazem;

(B) atropine (either 0.4 mg/ml or 1.0 mg/ml);

(C) aspirin 160 or 325 mg dose;

(D) beta blocker:

(i) esmolol;

(ii) propranolol;

(iii) atenolol; or

(iv) metoprolol;

(E) epinephrine 1 mg:

(i) 1:1,000 solution; and

(ii) 1:10,000 solution;

(F) diuretic: furosemide 10mg/ml;

(G) nitroglycerin (tablet or spray);

(H) vasodilators:

(i) labetalol; and

(ii) hydrazaline or diazoxide;

(I) vasopressors:

(i) ephedrine; and

(ii) phenylephrine;

(J) corticosteroids:

(i) dexamethasone;

(ii) hydrocortisone sodium succinate; or

(iii) methylprednisolone sodium succinate;

(K) dantrolene (must be in facility for offices in which agents causing malignant hypothermia are used);

(L) dextrose 50%;

(M) diphenhydramine;

(N) reversal agents:

(i) naloxone; and

(ii) flumazenil;

(O) opioid: morphine;

(P) procaine 10 mg/ml; and

(Q) succinylcholine.

(d) All practitioners who are being evaluated pursuant to Sections 20-123b-1 through 20-123b-9, inclusive, of the Regulations of Connecticut State Agencies, or who have been issued a permit pursuant to Section 20-123b of the Connecticut General Statutes, shall maintain anesthesia or conscious sedation records which include the date of procedure, nothing by mouth (NPO) status, availability of responsible adult escort, allergies, vital signs, drugs, and doses administered.

(Effective January 27, 1994; Amended November 4, 2004)