(a)

1. (1) These guidelines are designed to encourage a high level of quality care in the dental office setting.
2. (2) It should be recognized that emergency situations may require that these standards be modified based on the judgment of the clinician or clinicians responsible for the delivery of anesthesia care services.
3. (3) Changing technology and Arkansas rules or laws may also modify the standards listed herein.

(b)

1. (1) Before the administration of sedation or general anesthesia, a complete written medical history must be obtained, which shall include previous and current:

   1. (A) Medications;
   2. (B) Vital signs;
   3. (C) Allergies; and
   4. (D) Sensitivities.
2. (2) The recording of appropriate vital signs is required for all levels of sedation.
3. (3) The patient's weight should be recorded when appropriate.
4. (4) Patients with significant medical considerations (ASA III or IV) may require consultation with their primary care physician or consulting medical specialist as well as written clearance for treatment from that physician.

(d)

1. (1) Each licensed dentist administering deep sedation or general anesthesia must provide for training in emergency procedures to his or her qualified staff personnel.
2. (2) Emergency preparedness updates or drills for all staff must be held at least annually.

(e)

1. (1) A dentist who administers any type of sedation or general anesthesia shall maintain emergency equipment and medications appropriate for patient resuscitation.

2. (2) That dentist shall be proficient in handling emergencies and complications to include:

   1. (A) The maintenance of respiration and circulation;
   2. (B) The immediate establishment of a patent airway; and
   3. (C) Cardiopulmonary resuscitation.
3. (3) The dentist shall maintain appropriate emergency equipment and medications in the dental facility.

(j) Supervision of dental auxiliaries monitoring sedated patients:

1. (1) Personal supervision is required for minimal and moderate sedation;
2. (2) Operative supervision is required for deep sedation and general anesthesia; and
3. (3) Personal supervision is required for qualified staff who continuously monitor post-surgical patients before final evaluation and discharge by the dentist.