(A) A supervising anesthesiologist shall supervise an anesthesiologist assistant within the terms, conditions, and limitations set forth in a written practice protocol that is consistent with section 4760.09 of the Revised Code and this chapter of the Administrative Code. This supervision shall be direct supervision and in the immediate presence of the anesthesiologist assistant. "Direct supervision and in the immediate presence of" means all of the following:
(1) The supervising anesthesiologist shall remain physically present and available for immediate diagnosis and treatment of emergencies;
(2) The supervising anesthesiologist shall be physically present in the anesthetizing area or operating suite, as defined by the hospital or ambulatory surgical facility, and accessible by beeper, phone, or overhead page, such that he or she is immediately available to participate directly in the care of the patient with whom the anesthesiologist assistant and the supervising anesthesiologist are jointly involved;
(3) The supervising anesthesiologist shall personally participate in the most demanding procedures in the anesthesia plan, which shall include induction and emergence; and
(4) "Direct supervision and in the immediate presence of" shall not be interpreted to:
(a) Require the supervising anesthesiologist's presence in the same room as the anesthesiologist assistant for the duration of anesthetic management; or
(b) Prohibit the supervising anesthesiologist from addressing an emergency of short duration, administering labor analgesia or performing duties of short duration as required of a perioperative specialist in another location in the hospital or ambulatory surgical facility.
(B) An anesthesiologist assistant shall only perform those tasks assigned on a case-by-case basis by the supervising anesthesiologist. The anesthesiologist assistant shall implement the personalized plan for each patient as individually prescribed by the supervising anesthesiologist after that physician has completed a specific assessment of each patient. In determining which anesthetic procedures to assign to an anesthesiologist assistant, a supervising anesthesiologist shall consider all of the following:
(1) The education, training and experience of the anesthesiologist assistant;
(3) The conditions on the practice of the anesthesiologist assistant set out in the written practice protocol;
(4) The physical status of the patient according to the physical status classification system of the american society of anesthesiologists, as in effect at the time the assignment of procedures is made. The classification system is available from the american society of anesthesiologists and shall be posted on the board's website;
(5) The invasiveness of the anesthetic procedure;
(6) The level of risk of the anesthetic procedure;
(7) The incidence of complications of the anesthetic procedure;
(8) The physical proximity of the supervising anesthesiologist and the anesthesiologist assistant or assistants he or she may be supervising concurrently; and
(9) The number of patients whose care is being supervised concurrently by the supervising anesthesiologist.
(C) During the first four years of an anesthesiologist assistant's practice, the supervising anesthesiologist shall provide enhanced supervision as defined in this chapter of the Administrative Code.
(D) The supervising anesthesiologist retains responsibility for the anesthetic management in which the anesthesiologist assistant has participated.
Prior History: (Eff 5-30-03
Rule promulgated under: RC 119.03
Rule authorized by: RC 4731.05, 4760.08, 4760.19
Rule amplifies: RC 4731.22, 4760.08, 4760.09
R.C. 119.032 review dates: 05/30/2008 )