1. (1) There shall be a direct, continuing and close supervisory relationship between the anesthesiologist assistant and the anesthesiologist to whom the assistant is registered. The supervising anesthesiologist shall, at all times, be responsible for the activities of the anesthesiologist assistant.

2. (2) The anesthesiologist assistant shall provide medical services within the education, training, and experience of the anesthesiologist assistant that are delegated by the supervising anesthesiologist. These services include, but are not limited to:

   1. (a) Administers anesthesia under the supervision of an anesthesiologist.
   2. (b) Performs initial acute cardio-pulmonary resuscitation in life-threatening situations as directed by a physician.
   3. (c) Establishes multi-parameter monitoring of patients prior to, during and after anesthesia or in other acute care situations. This may include invasive/non-invasive monitoring under the direct supervision of an anesthesiologist. Also, other monitoring as may be developed for anesthesia and intensive care use may be incorporated.
   4. (d) Manages perioperative anesthetic care, including ventilatory support and other respiratory care parameters as directed by an anesthesiologist.
   5. (e) Assists in research projects as carried out by an anesthesiologist.
   6. (f) Instructs others in principles and practices of anesthesia, respiratory care and cardiopulmonary resuscitation as directed by the anesthesiologist.
   7. (g) Assists an anesthesiologist in gathering routine perioperative data.

   8. (h) The choice of anesthesia and drugs to be employed are prescribed by anesthesiologist for each patient except:

      1. 1. where standard orders for the conduct of a specified anesthetic are prescribed; and
      2. 2. where life-threatening emergencies arise necessitating the utilization of standard therapeutic or resuscitation procedures. An anesthesiologist will be immediately available for consultation regarding changes from standard procedures.
3. (3) The job description in the form specified in Appendix F to Chapter 7 is approved by the Board as a model job description which shall be acceptable to the Board if submitted by a qualified applicant for registration in compliance with Rule 540-X-7-.48.
4. (4) An anesthesiologist assistant is prohibited from performing any medical service, procedure, function, or activity which is not listed in the job description approved by the Board.
5. (5) Requests for changes in the job description of the assistant, including addition of specialized duties and tasks, shall be submitted, in writing, by the supervising anesthesiologist to the Board for prior approval.
6. (6) Should the supervising anesthesiologist contemplate a request for additional duties for the assistant for addition to the assistant’s Job Description, a written request shall be submitted to and approved by the Board prior to any additional duty or procedure being performed by the assistant.
7. (7) When any addition of a duty or procedure to the assistant’s Job Description is contemplated, a written request for training of the assistant in the duty or procedure shall be submitted to and approved by the Board prior to the assistant actually receiving any training in the duty or procedure.

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners

Statutory Authority: Code of Ala. 1975, §§34-24-290 thru 34-24-303.

Editor’s Note: Previous Rule 540-X-7-.55 was renumbered to .58 as per certification filed September 11, 2008; effective October 16, 2008.

History: New Rule: 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 September 11, 2008; effective October 16, 2008.