22 Tex. Admin. Code § 173.1 - General Definitions
The following words and terms when used in this chapter shall have the following meanings, unless the contents indicate otherwise:
(1) ACLS--Advanced Cardiac Life Support, as
defined by the AHA.
(2)
AED--Automatic External Defibrillator.
(3) AHA--American Heart
Association.
(4) Anesthesia--Use of
local anesthetics, analgesics, anxiolytics, or hypnotics to create a loss of
feeling, sensation, or consciousness by interrupting or depressing nerve and/or
brain function.
(5) Anesthesia
Services--The use of anesthesia for the performance of Level II- IV
services.
(6)
Anxiolytics--Dangerous or scheduled drugs used to provide sedation or to treat
episodes of anxiety.
(7)
ASHI--American Safety and Health Institute.
(8) ASA--American Society of
Anesthesiologists.
(9) BLS--Basic
Life Support, as defined by the AHA.
(10) Certified registered nurse anesthetist
(CRNA)--A person licensed by the Texas Board of Nursing (TBON) as a certified
registered nurse anesthetist.
(11)
Dangerous drugs--Medications defined by Chapter 483, Texas Health and Safety
Code. Dangerous drugs require a prescription but are not included in the list
of scheduled drugs. A dangerous drug bears the legend "Caution: federal law
prohibits dispensing without a prescription" or "Prescription Only."
(12) Deep sedation--a drug-induced depression
of consciousness during which patients cannot be easily aroused but respond
purposefully following repeated or painful stimulation. The ability to
independently maintain ventilatory function may be impaired. Patients may
require assistance in maintaining a patent airway, and spontaneous ventilation
may be inadequate. Cardiovascular function is usually maintained.
(13) General anesthesia--a drug-induced loss
of consciousness during which patients are not arousable, even by painful
stimulation. The ability to independently maintain ventilatory function is
often impaired. Patients often require 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.
(14) Hypnotics--Dangerous or scheduled drugs
that alter consciousness. This includes inhaled anesthetics and nonvolatile
anesthetic agents such as barbiturates, benzodiazepines, opioids, Etomidate,
Propofol, and Ketamine.
(15) Level
I services.
(A) Delivery of narcotic
analgesics or anxiolytics by mouth, as prescribed for the patient on order of a
physician, at a dose level not to exceed minimal sedation, as defined under
this chapter; or
(B) Delivery of
nitrous oxide/oxygen inhalation sedation.
(16) Level II services.
(A) The administration of tumescent
anesthesia;
(B) The delivery of
tumescent anesthesia in conjunction with the delivery of narcotic analgesics or
anxiolytics by mouth in dosages as defined under Level I, as prescribed for the
patient on order of a physician; or
(C) Except for the performance of Mohs
micrographic surgery, the administration of local anesthesia, peripheral nerve
blocks, or both in a total dosage amount that exceeds 50 percent of the
recommended maximum safe dosage per outpatient visit.
(17) Level III services-- Intravenous,
intramuscular, mucosal, rectal or inhalational delivery of narcotic analgesics,
anxiolytics, or hypnotics to achieve moderate sedation, as defined under this
Chapter. Level III services do not include deep sedation or general
anesthesia.
(18) Level IV
services--The use of regional or neuraxial anesthesia and/or the use of
anxiolytics, narcotic analgesics, and/or hypnotics to establish deep sedation
or general anesthesia, as defined under this Chapter.
(19) Local anesthetics--Dangerous drugs
administered topically or by injection, which interrupt nerve conduction,
temporarily creating a loss of sensation to an affected area.
(20) Minimal sedation--a drug-induced state
during which patients respond appropriately to verbal commands. Although
cognitive function and physical coordination may be impaired, airway reflexes,
and ventilatory and cardiovascular functions are unaffected.
(21) Moderate sedation--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.
(22) Narcotic
analgesics--Opioid or opioid-like dangerous or scheduled drugs that alleviate
pain, but not including non-opioid based drugs such as acetaminophen or
non-steroidal anti-inflammatory drugs (NSAIDs).
(23) Neuraxial anesthesia--the administration
of dangerous drugs or controlled substances into the subarachnoid space or
epidural space to produce anesthesia and analgesia. This includes spinal,
epidural and caudal anesthesia.
(24) Outpatient setting--Any facility,
clinic, center, office, or other setting that is not a part of a licensed
hospital or a licensed ambulatory surgical center with the exception of the
following:
(A) a clinic located on land
recognized as tribal land by the federal government and maintained or operated
by a federally recognized Indian tribe or tribal organization as listed by the
United States secretary of the interior under 25 U.S.C. §479-1 or as
listed under a successor federal statute or regulation;
(B) a facility maintained or operated by a
state or governmental entity;
(C) a
clinic directly maintained or operated by the United States or by any of its
departments, officers, or agencies; and
(D) an outpatient setting where the facility
itself is accredited by either The Joint Commission relating to ambulatory
surgical centers, the American Association for Accreditation of Ambulatory
Surgery Facilities, or the Accreditation Association for Ambulatory Health
Care.
(25)
PALS--Pediatric Advanced Life Support, as defined by the AHA.
(26) PeRLS--Perioperative Resuscitation and
Life Support Certificate, as defined by the ASA
(27) Regional anesthesia--The injection of
local anesthetics into an area of the body directly adjacent to a peripheral
nerve, for the purpose of blocking the response to pain in the distribution of
sensation of that nerve.
(28)
Scheduled drugs--Medications defined by the Texas Controlled Substances Act,
Chapter 481, Texas Health and Safety Code.
(29) Tumescent anesthesia--A specialized type
of subcutaneous infiltration of a dilute mixture of local anesthetic and
epinephrine known as tumescent solution.
Notes
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No prior version found.