The 6-hour Board-approved course of instruction shall include but not be limited to the following:

1. A. 4 hours of didactic classroom training, including at least the following:

   1. (1) The history, philosophy, and psychology of nitrous oxide minimal sedation;
   2. (2) The definition and descriptions of the physiological and psychological aspects of pain and anxiety;
   3. (3) Concepts and management of pain and anxiety;
   4. (4) Indications and contraindications for nitrous oxide sedation;
   5. (5) Anatomy and physiology of pediatric and adult respiration;
   6. (6) Medical assessment of a patient before administration of nitrous oxide;
   7. (7) Moderate sedation, deep sedation, and general anesthesia versus nitrous oxide;
   8. (8) Pharmacological and physiological effects of nitrous oxide including drug interactions;
   9. (9) A description of the stages of drug induced central nervous system depression through all levels of consciousness and unconsciousness with emphasis on the distinction between the conscious and unconscious state;
   10. (10) Administering and monitoring the flow of nitrous oxide, including the monitoring of a patient’s vital functions;
   11. (11) Recognition and management of complications and medical emergencies;
   12. (12) Occupational exposure; and
   13. (13) Preventing, recognizing, and managing possible complications of inhalation sedation; and
2. B. 2 hours of clinical training, including the direct observation of the performance of procedures.

Authority: Health Occupations Article, §§4-205, 4-206.1, 4-206.2 4-206.3, 4-206.4, and 12-101, Annotated Code of Maryland

Effective date: November 18, 1977 (4:24 Md. R. 1806)

Chapter revised effective April 22, 1985 (12:8 Md. R. 803)

Regulation .01-1 adopted effective May 31, 2010 (37:11 Md. R. 765)

Regulation .02 amended effective January 21, 2002 (29:1 Md. R. 23); May 31, 2010 (37:11 Md. R. 765)

Regulation .03 amended effective January 21, 2002 (29:1 Md. R. 23); May 31, 2010 (37:11 Md. R. 765)

Regulations .04—.16 adopted effective May 31, 2010 (37:11 Md. R. 765)

Regulations .01—.16 repealed and new Regulations .01—.28 adopted effective April 29, 2013 (40:8 Md. R. 724)

Chapter revised effective November 24, 2016 (43:23 Md. R. 1279)

Chapter revised effective September 5, 2022 (49:18 Md. R. 819)