43-34-47. Regulation of sedation and rescue in office based surgeries; failure to comply.

As used in this Code section, the term:#

1. (1)

   ‘‘Deep sedation/analgesia’’ means a drug-induced depression of consciousness during which the patient cannot be easily aroused but can respond purposefully following repeated or painful stimulation.#

2. (2)

   ‘‘General anesthesia’’ means a state of unconsciousness intentionally produced by anesthetic agents, with absence of pain sensation over the entire body, in which the patient’s protective airway reflexes may be impaired and the patient may be unable to maintain a patent natural airway. Sedation that progresses to the point at which the patient’s protective airway reflexes are impaired and the patient is unable to maintain a patent natural airway is considered general anesthesia.#

3. (3)

   ‘‘Medispa’’ means a facility that offers a range of services for the purpose of improving an individual’s well-being or appearance, including medical and surgical procedures such as liposuction, laser procedures, intense pulsed light, and injection of cosmetic filling agents and neurotoxins, in a nontraditional setting.#

4. (4)

   ‘‘Minimal sedation’’ means a drug-induced state during which the patient responds normally to verbal commands.#

5. (5)

   ‘‘Moderate sedation/analgesia’’ means a drug-induced depression of consciousness during which the patient responds purposefully to verbal commands, either alone or accompanied by tactile stimulation.#

6. (6)

   ‘‘Office based surgery’’ means any surgery or invasive medical procedure requiring sedation, when performed in a location other than a hospital, hospital associated surgical center, or an ambulatory surgical facility, including, but not limited to, physicians’ offices and medispas.#

7. (7)

   ‘‘Rescue’’ means an intervention by a practitioner proficient in airway management and advanced life support to correct adverse physiologic consequences of the deeper-than-intended level of sedation and to return the patient to the originally intended level of sedation.#

8. (8)

   ‘‘Sedation’’ means minimal sedation, moderate sedation/analgesia, deep sedation/analgesia, or general anesthesia. This term shall not include local infiltration.#

No later than December 31, 2021, the board shall establish rules and regulations for the administration of sedation and rescue in office based surgeries to establish consistent standards, ensure continuing competency, and promote patient safety. Such rules and regulations shall include requirements on:#

1. (1)

   A properly equipped and maintained facility to ensure patient safety, which may be demonstrated by appropriate accreditation or certification;#

2. (2)

   Competency of the physician using sedation in the absence of an anesthesiologist or certified registered nurse anesthetist, including education and relevant training;#

3. (3)

   Sedation assessment and management;#

4. (4)

   Separation of surgical and sedation monitoring functions;#

5. (5)

   Emergency care and transfer protocols in the event of a complication or emergency;#

6. (6)

   Maintenance of complete and accurate medical records relating specifically to the sedation of the patient;#

7. (7)

   Appropriate training and education in the safe and effective performance of all office based surgical procedures performed;#

8. (8)

   Reporting of adverse events to the board; and#

9. (9)

   Truth in advertising regarding the credentials, education, and training of the individuals administering sedation.#

Any physician administering sedation during office based surgery shall be subject to the rules and regulations established by the board pursuant to this Code section.#

Except as otherwise provided in subsection (e) of this Code section, any person who administers sedation during office based surgery in this state without a license to practice medicine from the board shall be deemed to be engaged in the unlawful practice of medicine and subject to the provisions of Code Sections 43-34-39 and 43-34-42.#

1. (1)

   Nothing in this Code section shall be construed to prevent a dentist licensed in this state with a permit issued by the Georgia Board of Dentistry pursuant to Code Section 43-11-21 from administering conscious sedation in a dental facility or during the practice of dentistry in a medispa or to deem a dentist licensed in this state to be engaged in the unlawful practice of medicine.#

2. (2)

   Nothing in this Code section shall be construed to prevent a certified registered nurse anesthetist licensed in this state from administering conscious sedation or anesthesia pursuant to Code Section 43-26-11.1, subsection (h) of Code Section 43-11-21, or paragraph (2) of subsection (d) of Code Section 43-11-21.1 or to deem a certified registered nurse anesthetist licensed in this state to be engaged in the unlawful practice of medicine.#

3. (3)

   Nothing in this Code section shall be construed to prevent a physician assistant licensed in this state who has completed a board approved anesthesiologist assistant program from administering conscious sedation or anesthesia or to deem such physician assistant to be engaged in the unlawful practice of medicine.#