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Register August 2020 No. 776
Chapter DE 11
ANESTHESIA
DE 11.01   Authority and purpose.
DE 11.02   Definitions.
DE 11.025   Permit to administer anesthesia.
DE 11.03   Requirements for nitrous oxide in combination with sedative agent.
DE 11.035   Board approved education program content.
DE 11.075   Continuing education.
DE 11.085   Auxiliary Personnel.
DE 11.09   Standards of care.
DE 11.10   Reporting of adverse occurrences related to sedation or anesthesia administration.
DE 11.01 DE 11.01 Authority and purpose. The rules in this chapter are adopted under authority in ss. 15.08 (5) (b), 227.11 (2) (a) and 447.02 (2) (b), Stats., for the purpose of defining standards for the administration of anesthesia by dentists. The standards specified in this chapter shall apply equally to general anesthesia and sedation, regardless of the route of administration.
DE 11.01 History History: Cr. Register, August, 1985, No. 356, eff. 9-1-85; am. Register, October, 1988, No. 394, eff. 11-1-88; am. Register, August, 1991, No. 428, eff. 9-1-91.
DE 11.02 DE 11.02 Definitions. In this chapter,
DE 11.02(1g) (1g) “ ASA” means American Society of Anesthesiologists.
DE 11.02(1s) (1s)“Class I permit" means a sedation permit issued prior to September 1, 2020. This permit is no longer valid.
DE 11.02(1t) (1t)“Class II permit - enteral" means a sedation permit enabling a dentist to administer, by enteral route, moderate sedation.
DE 11.02(1tm) (1tm) “Class II permit – parenteral” means a sedation permit enabling a dentist to administer, by parenteral route, moderate sedation.
DE 11.02(1u) (1u)“Class III permit" means a sedation permit enabling a dentist to administer moderate or deep sedation, or general anesthesia.
DE 11.02(2g) (2g) “ Continual” means repeated regularly and frequently in a steady succession.
DE 11.02(2r) (2r) “ Continuous” means prolonged without any interruption at any time.
DE 11.02(3) (3)“Deep sedation" means a drug-induced depression of consciousness during which a patient cannot be easily aroused but responds purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. A patient may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.
DE 11.02(3m) (3m) “ Enteral” means administration by which the agent is absorbed through the gastrointestinal tract or through the oral, rectal, or nasal mucosa.
DE 11.02(4) (4)“General anesthesia" means drug-induced loss of consciousness during which a patient is not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. A patient often requires assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.
DE 11.02(4e) (4e) “ Immediately available” means physically located in the dental office or facility and ready for immediate use or response.
DE 11.02(4m) (4m) “ Minimal sedation” means a minimally depressed level of consciousness, produced by a pharmacological method that retains the patient's ability to independently and continuously maintain an airway and respond normally to tactile stimulation and verbal command. Although cognitive function and coordination may be modestly impaired, ventilatory and cardiovascular functions are unaffected.
DE 11.02(4s) (4s) “ Moderate sedation” means a drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular function is usually maintained. If more than one enteral drug is administered or if an enteral drug is administered at a dosage that exceeds the maximum recommended dose during a single appointment, such administration is considered moderate sedation.
DE 11.02(6) (6)“Nitrous oxide" means a combination of nitrous oxide and oxygen.
DE 11.02(6g) (6g) “ Parenteral” means administration by which the drug bypasses the gastrointestinal tract through intramuscular, intravenous, intranasal, submucosal, subcutaneous, or intraocular methods.
DE 11.02(6r) (6r) “ Pediatric patient” means a patient who is 12 years old and under.
DE 11.02(10) (10)“Time-oriented anesthesia record" means documentation at appropriate intervals of drugs, doses and physiologic data obtained during patient monitoring.
DE 11.02 History History: Cr. Register, August, 1985, No. 356, eff. 9-1-85; r. and recr. Register, October, 1988, No. 394, eff. 11-1-88; r. (4), renum. (1) to (3) to be (2) to (4) and am., cr. (1) and (5), Register, August, 1991, No. 428, eff. 9-1-91; CR 04-095: am. (1) to (4), cr. (1m) and (6) to (10), r. (5) Register August 2006 No. 608, eff. 1-1-07; CR 13-061: cr. (1s) to (1u) Register June 2014 No. 702, eff. 7-1-14; CR 19-132: r. (1), cr. (1g), r. (1m), am. (1s), (1t), cr. (1tm), am. (1u), r. (2), cr. (2g), (2r), am. (3), cr. (3m), am. (4), cr. (4e), (4m), (4s), am. (6), cr. (6g), (6r), r. (7) to (9) Register August 2020 No. 776, eff. 9-1-20; correction in (3) made under s. 35.17, Stats., Register August 2020 No. 776.
DE 11.025 DE 11.025Permit to administer anesthesia.
DE 11.025(1)(1)Minimal sedation does not require a permit.
DE 11.025(2) (2) The board may issue an anesthesia permit at the following levels:
DE 11.025(2)(a) (a) Class II – enteral is for the administration of moderate sedation by enteral route.
DE 11.025(2)(b) (b) Class II – parenteral is for the administration of moderate sedation by either enteral or parenteral route,
DE 11.025(2)(c) (c) Class III is for the administration of moderate or deep sedation, or general anesthesia.
DE 11.025(3) (3) A dentist may apply to the board for an anesthesia permit by submitting all of the following:
DE 11.025(3)(a) (a) Application and fee.
DE 11.025(3)(b) (b) Verification of any permit or credential authorizing anesthesia or sedation held by the dentist.
DE 11.025(3)(c) (c) Disclosure of any previous anesthesia or sedation-related incident, morbidity, or mortality or any board investigation or discipline relating to the delivery of anesthesia or sedation.
DE 11.025(3)(d) (d) Evidence of current licensure to practice dentistry in the state of Wisconsin.
DE 11.025(3)(e) (e) Evidence of certification in Advanced Cardiovascular Life Support or Pediatric Advanced Life Support through a course that follows the American Heart Association guidelines. Pediatric Advanced Life Support is required if treating pediatric patients.
DE 11.025(3)(f) (f) Affidavit indicating the dentist has the required equipment and medications.
DE 11.025(3)(g) (g) If applying for a class II permit - enteral, evidence of one of the following:
DE 11.025(3)(g)1. 1. Current board certification or a candidate for board certification by the American Board of Oral and Maxillofacial Surgery.
DE 11.025(3)(g)2. 2. Completion of an accredited oral and maxillofacial surgery residency.
DE 11.025(3)(g)3. 3. Diplomate or candidate of the American Dental Board of Anesthesiology.
DE 11.025(3)(g)4. 4. Successful completion of a board approved education program that provides comprehensive training meeting the requirements in s. DE 11.035.
DE 11.025(3)(h) (h) If applying for a class II permit- parenteral, evidence of one of the following:
DE 11.025(3)(h)1. 1. Current board certification or a candidate for board certification by the American Board of Oral and Maxillofacial Surgery.
DE 11.025(3)(h)2. 2. Completion of an accredited oral and maxillofacial surgery residency.
DE 11.025(3)(h)3. 3. Diplomate or candidate of the American Dental Board of Anesthesiology.
DE 11.025(3)(h)4. 4. Successful completion of a board approved education program that provides comprehensive training meeting the requirements in s. DE 11.035.
DE 11.025(3)(i) (i) If applying for a class III permit, evidence of one of the following:
DE 11.025(3)(i)1. 1. Current board certification or a candidate for board certification by the American Board of Oral and Maxillofacial Surgery.
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Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date the chapter was last published.