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DE 11.09(3)(d) (d) Ventilation monitored by end-tidal carbon dioxide.
DE 11.09(3)(e) (e) Auscultation of breath sounds by precordial or pretrachial stethoscope.
DE 11.09(3)(f) (f) Respiration rate.
DE 11.09(3)(g) (g) Heart rate and rhythm via electrocardiogram.
DE 11.09(3)(h) (h) Blood pressure.
DE 11.09(3)(i) (i) Color of mucosa, skin or blood.
DE 11.09(3)(j) (j) Body temperature whenever triggering agents associated with malignant hyperthermia are administered.
DE 11.09(4) (4)Monitoring and evaluation of minimal sedation. A dentist administering minimal sedation shall continuously monitor and evaluate all of the following:
DE 11.09(4)(a) (a) Level of consciousness.
DE 11.09(4)(b) (b) Chest excursions.
DE 11.09(4)(c) (c) Ventilation by either auscultation of breath sounds or by verbal communication with the patient.
DE 11.09(4)(d) (d) Color of mucosa, skin or blood.
DE 11.09(4)(e) (e) Blood pressure, heart rate, and oxygenation saturation by pulse oximetry pre-operatively and post-operative and intraoperatively.
DE 11.09(5) (5)Recovery and discharge. A dentist shall maintain and implement recovery and discharge procedures which include all of the following:
DE 11.09(5)(a) (a) Immediate availability of oxygen and suction equipment.
DE 11.09(5)(b) (b) Monitor and document the patient's blood pressure, heart rate, oxygenation and level of consciousness during recovery.
DE 11.09(5)(c) (c) Determine and document that blood pressure, heart rate, level of consciousness, oxygenation, ventilation, and circulation are satisfactory for discharge.
DE 11.09(5)(d) (d) Post-operative verbal and written instructions provided.
DE 11.09(5)(e) (e) If a reversal agent is administered before discharge criteria have been met, the patient must be monitored until recovery is assured.
DE 11.09(6) (6)Equipment. A dentist administering anesthesia or sedation shall have immediately available and maintain equipment, appropriate for patients served, in good working order according to manufacturer's directions all the following equipment:
DE 11.09(6)(a) (a) Alternative light source for use during power failure.
DE 11.09(6)(b) (b) Automated external defibrillator.
DE 11.09(6)(c) (c) Disposable syringes in assorted sizes.
DE 11.09(6)(d) (d) Oxygen in a portable cylinder E tank capable of administering positive pressure ventilation via a bag-valve-mask system.
DE 11.09(6)(e) (e) Sphygmomanometer and stethoscope for pediatric and adult patients.
DE 11.09(6)(f) (f) Suction and backup system.
DE 11.09(6)(g) (g) An operating chair capable of withstanding cardiopulmonary resuscitation or a back board.
DE 11.09(6)(h) (h) Emergency airway equipment including oral and nasal airway and advanced airway devices for appropriate patient populations being served.
DE 11.09(7) (7)Drugs. A dentist administering anesthesia or sedation shall be responsible to maintain and properly store drugs in current and unexpired condition and properly dispose of expired drugs. The following drugs shall be maintained in an emergency drug kit:
DE 11.09(7)(a) (a) Non-enteric coated aspirin.
DE 11.09(7)(b) (b) Ammonia inhalants.
DE 11.09(7)(c) (c) Antihistamine.
DE 11.09(7)(d) (d) Antihypoglycemic agent.
DE 11.09(7)(e) (e) Bronchodilator.
DE 11.09(7)(f) (f) Epinephrine.
DE 11.09(7)(g) (g) Oxygen.
DE 11.09(7)(h) (h) Nitroglycerin.
DE 11.09(7)(i) (i) Reversal agents.
DE 11.09(7)(j) (j) Muscle relaxant.
DE 11.09(8) (8)Emergency management. A dentist administering anesthesia or sedation shall be responsible for the sedative or anesthetic management, diagnosis and treatment of emergencies related to the administration of anesthesia or sedation and for ensuring the equipment, drugs and protocols for patient rescue are immediately available.
DE 11.09(9) (9)Anesthesia record. A dentist shall maintain an anesthesia record that documents all events related to the administration of the sedative or anesthetic agents, including all of the following:
DE 11.09(9)(a) (a) Time-oriented anesthesia record that includes the date, names of all drugs administered, dosages, methods of administration and monitored physiological parameters.
DE 11.09(9)(b) (b) Heart rate, respiratory rate, blood pressure, pulse oximetry, and end-tidal carbon dioxide measurements shall be recorded in 5-minute intervals for general anesthesia, deep and moderate sedation.
DE 11.09(9)(c) (c) The duration of the procedure.
DE 11.09(9)(d) (d) The individuals present during the procedure.
DE 11.09 History History: CR 04-095: cr. Register August 2006 No. 608, eff. 1-1-07; CR 19-132: r. and recr. Register August 2020 No. 776, eff. 9-1-20; correction in (2) (e) made under s. 35.17, Stats., Register August 2020 No. 776.
DE 11.10 DE 11.10 Reporting of adverse occurrences related to sedation or anesthesia administration.
DE 11.10(1m) (1m) A dentist shall report to the board any anesthesia-related or sedation-related mortality which occurs during or as a result of treatment provided by the dentist within 2 business days of the dentist's notice of such mortality.
DE 11.10(2m) (2m) A dentist shall report any morbidity which may result in permanent physical or mental injury as a result of the administration of anesthesia or sedation by the dentist to the board within 30 days of the notice of the occurrence of any such morbidity.
DE 11.10(3m) (3m)The report shall include all of the following:
DE 11.10(3m)(a) (a) A description of the dental procedures.
DE 11.10(3m)(b) (b) The names of all participants in the dental procedure and any witnesses to the adverse occurrence.
DE 11.10(3m)(c) (c) A description of the preoperative physical condition of the patient.
DE 11.10(3m)(d) (d) A list of drugs and dosage administered before and during the dental procedures.
DE 11.10(3m)(e) (e) A detailed description of the techniques utilized in the administration of all drugs used during the dental procedure.
DE 11.10(3m)(f) (f) A description of the adverse occurrence, including the symptoms of any complications, any treatment given to the patient, and any patient response to the treatment.
DE 11.10(3m)(g) (g) A description of the patient's condition upon termination of any dental procedures undertaken.
DE 11.10 Note Note: Forms are available at the office of the Dentistry Examining Board located at 1400 East Washington Avenue, P.O. Box 8935, Madison, WI 53708.
DE 11.10 History History: CR 04-095: cr. Register August 2006 No. 608, eff. 1-1-07; CR 19-132: r. (intro.), renum. (1) to (7) to (3) (a) to (g), cr. (1m), (2m), (3m) (intro.) Register August 2020 No. 776, eff. 9-1-20; correction in (1m) made under s. 35.17, Stats., and renum. (3) (a) to (g) to (3m) (a) to (g) under s. 13.92 (4) (b) 7., Stats., Register August 2020 No. 776.
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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.