1. (1) Anesthesiologist supervision requires, at all times, a direct, continuing and close supervisory relationship between an anesthesiologist assistant and the supervising anesthesiologist to whom the assistant is registered or an anesthesiologist who is acting in a Board-approved supervisory role to the anesthesiologist assistant.
2. (2) Supervision does not, necessarily, require the constant physical presence of the supervising anesthesiologist or an anesthesiologist who is acting in a Board-approved supervisory role to the anesthesiologist assistant; however, the anesthesiologist must remain readily available in the facility.
3. (3) Except in life-threatening situations, the supervising anesthesiologist shall be readily available for personal supervision and shall be responsible for pre-operative, intra-operative and post-operative care.
4. (4) The supervising anesthesiologist shall insure that, with respect to each patient, all activities, functions, services and treatment measures are immediately and properly documented in written form by the anesthesiologist assistant. All written entries shall be reviewed, countersigned, and dated by the supervising anesthesiologist. The supervising anesthesiologist’s signature on the anesthetic record will fulfill this requirement for all written entries on the anesthetic record.
5. (5) All of the above is to emphasize that there shall be no independent, unsupervised practice by anesthesiologist assistants.
6. (6) In the event of an unanticipated, permanent absence of a supervising anesthesiologist, a previously approved covering anesthesiologist may be designated as a temporary supervising anesthesiologist for a period of up to sixty (60) days. During the sixty (60) day time period, a new registration agreement designating a new supervising anesthesiologist should be submitted for approval.
7. (7) In the event of a national emergency duly declared by Federal officials or in the event of a natural disaster or state emergency duly declared by the Governor, an anesthesiologist assistant may provide emergency medical treatment without immediate physician supervision or direction to patients within the affected areas of the state, provided that the treatment is within the scope of assistant’s education, training and approved job description. In the administration of anesthetic agents during the course of surgery, the assistant shall be directed by a licensed physician. The anesthesiologist assistant in such circumstance shall make reasonable efforts to inform his supervising physician of the location and type of emergency medical services being provided and shall act in conformance with the direction of local medical supervisors. The authority granted under this paragraph shall extend only for the duration of the declared national emergency or state emergency or natural disaster.

Author: Alabama Board of Medical Examiners

Statutory Authority: Code of Ala. 1975, §§34-24-290, et. seq.

Editor’s Note: Previous Rule 540-X-7-.53 was renumbered to .56 as per certification filed September 11, 2008; effective October 16, 2008.

History: Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed November 19, 2004; effective December 24, 2004. Amended (Rule Number Only): Filed September 11, 2008; effective October 16, 2008. Amended: Filed October 19, 2017; effective December 3, 2017. Amended: Published November 30, 2020; effective January 14, 2021.