234 CMR, § 6.06 - Facility Permit D-B2: Facility Requirements for Administration of Minimal Sedation and/or Nitrous Oxide-oxygen in Conjunction with an Enteral Agent Dispensed or Administered in a Dental Facility

(1) Application. An applicant shall submit an accurate and complete application on form(s) provided by the Board and accompanied by the permit fee to be determined annually by the Executive Office of Administration and Finance. The application shall, at a minimum, include the following:

(a) Applicant name and Massachusetts dental license number;

(b) Name(s) of dental establishment(s), owner(s) of said establishment, and address(es) of the site(s) where anesthesia will be administered;

(c) Documentation of provision and maintenance of equipment, materials, and drugs required for the administration of minimal and nitrous oxide-oxygen sedation;

(d) A written request for an on-site inspection conducted by the Board; and

(e) Any other information as may be requested by the Board.

(2) Equipment Required for a Facility Permit D-B2. The following equipment shall be required to be provided and maintained on-site:

(a) Alternative light source for use during power failure;

(b) Automated or manual external defibrillator;

(c) Disposable CPR masks (pediatric and adult);

(d) Disposable syringes, assorted sizes

(e) Equipment suitable for proper positioning of the patient for administration of cardiopulmonary resuscitation, including a back board;

(f) Gas delivery system capable of positive pressure ventilation, which must include:

1. Oxygen;

2. Safety-keyed hose attachments;

3. Capability to administer 100% oxygen in all rooms (operatory, recovery, examination, and reception);

4. Gas storage in compliance with safety codes;

5. Adequate waste gas scavenging; and

6. Nasal hood or cannula.

(g) Latex free tourniquet;

(h) Means of monitoring vital signs (pediatric and adult);

(i) Oxygen (portable Cylinder E tank) pediatric and adult masks capable of giving positive pressure ventilation (including bag-valve-mask system);

(j) Pulse oximeter with battery pack;

(k) Sphygmomanometer and stethoscope (pediatric and adult);

(l) Suction;

(m) Supervised area for recovery; and

(n) Any other equipment as may be required by the Board.

(3) Drugs Required for a Facility Permit D B-2. The following drugs and/or categories of drugs shall be provided and maintained in accordance with the AHA/ACLS Guidelines ( 234 CMR 6.02) or as determined by the Board for emergency use. All drugs shall be current and not expired.

(a) Acetylsalicylic acid (readily absorbable form);

(b) Ammonia inhalants;

(c) Anticonvulsant;

(d) Antihistamine;

(e) Antihypoglycemic agent;

(f) Bronchodilator;

(g) Corticosteroid;

(h) Epinephrine-preloaded syringes (pediatric and adult);

(i) Oxygen;

(j) Reversal agents;

(k) Two epinephrine ampules;

(l) Vasodilator;

(m) Vasopressor; and

(n) Any other drugs or categories of drugs as may be required by the Board.

Notes

234 CMR, § 6.06