1. A. A physician who performs office-based surgery using sedation shall ensure that before a health care professional participates in or staff member assists with office-based surgery using sedation, the health care professional and staff member receive instruction in the following:

   1. 1. Policy and procedure in cases of emergency,
   2. 2. Policy and procedure for office evacuation, and
   3. 3. Safe and timely patient transfer to a local accredited hospital.

2. B. When performing office-based surgery using sedation, a physician may use volatile agents or other medications that are known to trigger malignant hyperthermia. If the physician uses volatile agents or medications that may trigger malignant hyperthermia, the physician shall:

   1. 1. Use ASA standard monitors, including ETCO2 and temperature;

   2. 2. Have immediately available in the area in which office-based surgery is performed:

      1. a. Appropriate medications, including dantrolene (unexpired),
      2. b. Equipment necessary for monitoring, and
      3. c. Written protocols regarding use of the volatile agents and medications.

Historical Note

New Section R4-16-708 renumbered from R4-16-707 and amended by final rulemaking at 31 A.A.R. 4386 (November 21, 2025), effective January 3, 2026 (Supp. 25-4).