Monitoring in the recovery area shall be performed by dedicated personnel, trained in their specific job skills as determined by the registered physician, and must include pulse oximetry and non-invasive blood pressure measurement. The recovery area must be staffed by an appropriate number of people for the patients being monitored. The patient must be assessed periodically for level of consciousness, pain relief, or any untoward complication. Each patient must meet discharge criteria as established by the practice prior to leaving the physician office. Documented recovery from anesthesia must include the following: 1) vital signs and oxygen saturation stable within acceptable limits; 2) no more than minimal nausea, vomiting, or dizziness; and 3) sufficient time (up to two (2) hours) must have elapsed following the last administration of reversal agents to ensure the patient does not become sedated after reversal effects have worn off. After meeting discharge criteria, the patient shall be given appropriate discharge instructions, discharged under the direction of the physician performing the procedure, and discharged under the care of a responsible third party. Discharge instructions shall include: 1) the procedure performed; 2) information about potential complications; 3) telephone numbers to be used by the patient to discuss with the registered physician complications or questions that may arise; 4) instructions for medications prescribed and pain management; 5) information regarding the follow-up visit date, time, and location; and 6) designated treatment facility in the event of an emergency. The use of reversal agents such as Narcan and flumazenil should be used with caution in the outpatient setting. The registered physician must be fully educated on the duration of action of these medications.

Author: Alabama Board of Medical Examiners

Statutory Authority: Code of Ala. 1975, §34-24-53.

Editor’s Note: Rule 540-X-10-.11 was renumbered .12 as per certification filed September 22, 2011; effective October 27, 2011.

History: New Rule: Filed October 17, 2003; effective November 21, 2003. Amended (Rule and Appendix D): Filed September 22, 2011; effective October 27, 2011. Amended (Rule and Appendix D): Filed August 15, 2018; effective September 29, 2018. Amended: Published February 26, 2021; effective April 12, 2021. Repealed and New Rule: Published January 30, 2026; effective March 16, 2026.