1. (1) If the hospital furnishes anesthesia services, they shall be provided in a well-organized manner under the direction of a qualified doctor of medicine or osteopathy. The service is responsible for all anesthesia administered in the hospital.

2. (2) Organization and staffing. The organization of anesthesia services shall be appropriate to the scope of the services offered. Anesthesia may only be administered by one of the following:

   1. (a) An anesthesiologist;
   2. (b) A doctor of medicine or osteopathy (other than an  anesthesiologist);
   3. (c) A dentist or oral surgeon;
   4. (d) A podiatrist, but limited to administering local anesthetics to the foot;
   5. (e) A certified registered nurse anesthetist (CRNA) who is performing or assisting in any act involving the  determination, preparation, administration, procedural ordering, or monitoring of any drug used to render an individual insensible to pain for surgical or other therapeutic or diagnostic procedures and who  is under the direction of or in coordination with a physician licensed to practice  medicine, a podiatrist or a dentist, who is immediately available; or
   6. (f) An anesthesiologist's assistant who is under the direction of an anesthesiologist who is immediately available.

3. (3) Delivery of services. Anesthesia services shall be consistent with needs and resources. Policies on anesthesia procedures shall include the delineation of pre-anesthesia and post-anesthesia responsibilities. The policies shall ensure that the following are provided for each patient:

   1. (a) A pre-anesthesia evaluation completed and documented by an individual qualified to administer anesthesia performed within 48 hours prior to surgery or a procedure  requiring anesthesia services.
   2. (b) An intra-operative anesthesia record.
   3. (c) A post-anesthesia evaluation completed and documented by an individual qualified to administer anesthesia, no later than 48 hours after surgery or a procedure requiring  anesthesia services. The post-anesthesia evaluation for anesthesia recovery shall be completed in accordance with  hospital policies and procedures that have been approved by the medical staff and that reflect current standards of anesthesia care.

Author: W.T. Geary, Jr., M.D., Carter Sims

Statutory Authority: Code of Ala. 1975, §§22-21-20, et seq.

History: Filed September 1, 1982. Repealed and New Rule: Filed November 18, 1994; effective December 23, 1994. Repealed and New Rule: Filed August 24, 2012; effective September 28, 2012. Amended: Published September 30, 2025; effective November 14, 2025.