034-5 Wyo. Code R. §§ 5-3 - Definitions

For the purpose of this chapter, the following definitions shall apply:

(a) "ACLS" means advanced cardiac life support.

(b) "Anxiolysis" is minimal sedation.

(c) "Applicant" means a Wyoming licensed dentist applying for a sedation permit.

(d) "ASA" means American Society of Anesthesiology classification.

(e) "Combination inhalation" means using an inhalation agent and a sedative agent at the same time.

(f) "Competent" means displaying special skill or knowledge derived from training and experience.

(g) "Deep sedation" means a drug-induced depression of consciousness during which the patient cannot be easily aroused but responds purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. The patient may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.

(h) "Dental hygienist" means a Wyoming licensed dental hygienist holding an appropriate expanded duties permit including local anesthesia and/or nitrous oxide anxiolysis.

(i) "Enteral" means a route of administration in which the agent is absorbed through the gastrointestinal tract or mucosa [i.e., oral, rectal, nasal, or sublingual].

(j) "Facility Permit" means a permit issued to any location where sedation is being performed that has been inspected and approved by the Board.

(k) "Facility Permit Holder" means a Wyoming licensed dentist designated as the responsible dentist for a facility permit.

(l) "General anesthesia" means a drug-induced loss of consciousness during which the patient is not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. The 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.

(m) "Inhalation" means a route of administration in which a gaseous or volatile agent is introduced into the pulmonary tree and whose primary effect is due to absorption through the pulmonary bed.

(n) "Local anesthesia" means the elimination of sensation, especially pain, in one part of the body by the topical application or regional injection of a drug.

(o) "Minimal sedation" (previously known as anxiolysis) 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. Minimal sedation includes administration of oral medication and/or nitrous oxide.

(p) "Moderate sedation" previously known as "conscious sedation and/or twilight sedation or parenteral sedation" means a drug-induced depression of consciousness during which the patient responds 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. The drugs and/or techniques used should carry a margin of safety wide enough to render unintended loss of consciousness unlikely. Repeated dosing of an agent before the effects of previous dosing can be fully appreciated may result in a greater alteration of the state of consciousness than is the intent of the sedation permit holder. Further, a patient whose only response is reflex withdrawal from a painful stimulus is not considered to be in a state of moderate sedation.

(q) "MRD" means maximum recommended dose of a drug as printed on Food and Drug Administration approved labeling for unmonitored home use.

(r) "Nitrous oxide anxiolysis" means the administration by inhalation of a combination of nitrous oxide and oxygen producing an altered level of consciousness that retains the patient's ability to independently and continuously maintain an airway and respond appropriately to physical stimulation or verbal command.

(s) "PALS" means Pediatric Advanced Life Support.

(t) "Parenteral" means a route of administration in which the drug bypasses the gastrointestinal tract [i.e., intramuscular, intravenous, intranasal, submucosal, subcutaneous, or intraosseous].

(u) "Qualified anesthesia provider" means a licensed anesthesiologist, certified registered nurse anesthetist, or sedation permit holder with appropriate sedation level permit.

(v) "Responsible dentist" means a licensed dentist who assumes responsibility for a facility permit.

(w) "Sedation Inspector" means a Board-approved inspector of sedation facilities and sedation permit applicant's surgical/anesthetic technique cases.

(x) "Sedation permit" means a permit issued by the Board for administration of moderate sedation or deep sedation and/or general anesthesia by a sedation permit holder.

(y) "Titration" means administration of multiple or incremental doses of a drug until a desired effect is reached. Knowledge of each drug's time of onset, peak response, and duration of action is essential to avoid over sedation. Although the concept of titration of a drug to effect is critical for patient safety, when the intent is moderate sedation one must know whether the previous dose has taken full effect before administering an additional drug increment.

Notes

034-5 Wyo. Code R. §§ 5-3

Amended, Eff. 1/8/2015. Amended, Eff. 9/26/2017. Amended, Eff. 1/14/2022. Amended, Eff. 5/29/2024.