1. (a) Each facility applying for a facility or a facility hosting permit shall have equipment and supplies on-site and proper staffing as follows:

   1. (1) Oxygen delivery systems as follows:

      1. a. Portable oxygen tank;
      2. b. Bag valve mask such as ambu bag with connector tubing able to be connected to oxygen tank; and
      3. c. Nasal cannula or oxygen mask with connector tubing able to be connected to oxygen tank;

   2. (2) Suction equipment as follows:

      1. a. Suction unit or vacuum system connected to all operatories and recovery rooms; and
      2. b. Yankauer suction tip with connector tubing able to be connected to suction unit or vacuum system;
   3. (3) Wheelchair;

   4. (4) Vital signs monitoring equipment in all operatories where moderate sedation, deep sedation, or general anesthesia is administered and recovery rooms as follows:

      1. a. Continuous pulse oximeter; and
      2. b. Blood pressure monitor with cuffs of various sizes for adult patients, as well as for pediatric patients if patients under age 13 years are treated at the facility;

   5. (5) Defibrillator equipment as follows:

      1. a. Manual or automated external defibrillator (AED);
      2. b. Unexpired batteries for defibrillator, if the defibrillator is battery powered;
      3. c. Log maintained documenting monthly inspections for proper defibrillator functioning; and
      4. d. Unexpired adult defibrillator pads that connect to the facility’s defibrillator equipment, as well as unexpired pediatric defibrillator pads that connect to the facility’s defibrillator equipment if patients under age 8 years are treated at the facility;
   6. (6) Auxiliary light source capable of use during power failure, such as battery powered headlight, flashlight, or generator;
   7. (7) Rigid CPR board; and

   8. (8) Staffing for procedures under moderate sedation, deep sedation, or general anesthesia, in addition to the qualified provider, shall be as follows:

      1. a. The operating dentist, if separate from the qualified provider, maintains a current PALS certification if patients under the age of 13 years are treated at the facility;
      2. b. A dental assistant with current BLS certification on staff at the time of procedure;
      3. c. Additional personnel available when needed for calling emergency 911; and
      4. d. Staffing on site, as described in Den 304.08, appropriate for the procedure being performed.

2. (b) In addition to the requirements specified in Den 304.07(a), at the time that a qualified provider is administering moderate sedation, deep sedation, or general anesthesia, the facility shall have the following additional equipment and supplies on-site:

   1. (1) Oxygen and gas delivery systems as follows:

      1. a. Oxygen fail-safe valve on anesthesia machine or nitrous oxide flowmeter if administered; and
      2. b. Size-dissimilar fittings, varied hose sizes, and colored tubing and hoses for oxygen, nitrous oxide, and medical air if used;

   2. (2) Suction systems as follows:

      1. a. Pulmonary suction catheter with connector tubing able to be connected to suction unit or vacuum system; and
      2. b. Portable suction device able to be used during power failure;

   3. (3) Airway devices as follows:

      1. a. Endotracheal tubes (ETTs) of various sizes with stylets for adult patients, as well as for pediatric patients if patients under age 13 years are treated at the facility;
      2. b. Syringe for ETT cuff inflation;
      3. c. Ambu bag and connector tubing to enable ETT to be connected to oxygen tank and deliver positive pressure;
      4. d. If deep sedation or general anesthesia is provided at the facility, video laryngoscope with blades of various sizes for adult patients, as well as for pediatric patients if patients under age 13 years are treated at the facility;
      5. e. Extra batteries for laryngoscope;
      6. f. Extra bulbs for laryngoscope, if applicable;
      7. g. Magill forceps;
      8. h. Tongue grasping forceps;
      9. i. Oral airways of various sizes for adult patients, as well as for pediatric patients if patients under age 13 years are treated at facility;
      10. j. Nasopharyngeal airways of various sizes for adult patients, as well as for pediatric patients if patients under age 13 years are treated at facility:
      11. k. Supraglottic airways, such as Laryngeal Mask Airways or King Airways, of various sizes for adult patients, as well as for pediatric patients if patients under age 13 years are treated at facility; and
      12. l. If deep sedation or general anesthesia is provided at the facility, emergency cricothyrotomy kit with connector tubing able to be connected to bag valve mask and oxygen tank;

   4. (4) Vital signs monitoring equipment in all operatories where moderate sedation, deep sedation, or general anesthesia is administered also with:

      1. a. Continuous electrocardiogram;
      2. b. Capnography; and
      3. c. Stethoscope; and

   5. (5) Accessory supplies and emergency medications as follows:

      1. a. Disposable angiocatheters, tourniquets, and tape for IV catheter placement;
      2. b. IV tubing and IV fluids;
      3. c. Disposable needles and syringes for medication draw up and delivery;
      4. d. Epinephrine 1:10,000 for cardiac arrest;
      5. e. Epinephrine 1:1,000 for allergic reaction;
      6. f. Direct or indirect acting pressor for hypotension;
      7. g. Antiarrhythmic for cardiac arrest;
      8. h. Adenosine for tachycardia;
      9. i. Naloxone for opioid reversal;
      10. j. Flumazenil for benzodiazepine reversal;
      11. k. Antihypertensive for acute hypertension;
      12. l. Steroid injection for allergic reaction;
      13. m. Dextrose injection for hypoglycemic reversal;
      14. n. Atropine for bradycardia;
      15. o. Diphenhydramine injection for allergic reaction;
      16. p. Neuromuscular blocker with rapid onset for laryngospasm;
      17. q. Albuterol inhaler for bronchospasm;
      18. r. Benzodiazepine injection for seizure;
      19. s. Immediate-release non-enteric coated aspirin for acute coronary syndrome; and
      20. t. Sublingual nitroglycerin for acute coronary syndrome.

3. (c) In addition to the requirements specified in Den 304.07(b), at the time that a qualified provider is administering inhaled volatile anesthetics, or succinylcholine if administered on a routine basis, the facility shall have the following additional equipment and supplies on-site:

   1. (1) Oxygen and gas delivery system also with anesthetic gas analyzer if inhaled volatile anesthetics are used;
   2. (2) Dantrolene injection for malignant hyperthermia; and
   3. (3) Sterile water for dantrolene diluent;

Source. #14246, eff 8-3-25, EXPIRES: 8-3-35