Chief Sponsor: Michael S. Kennedy

House Sponsor: Steve Eliason


8     General Description:
9          This bill modifies requirements related to anesthesia and sedation provisions.
10     Highlighted Provisions:
11          This bill:
12          ▸     allows an anesthesia provider who is providing ketamine for a non-anesthetic
13     purpose to have an individual with airway training on site rather than in the
14     procedure room.
15     Money Appropriated in this Bill:
16          None
17     Other Special Clauses:
18          None
19     Utah Code Sections Affected:
20     AMENDS:
21          58-1-510, as enacted by Laws of Utah 2022, Chapter 379

23     Be it enacted by the Legislature of the state of Utah:
24          Section 1. Section 58-1-510 is amended to read:
25          58-1-510. Anesthesia and sedation requirements -- Unprofessional conduct --
26     Whistleblower protection.
27          (1) As used in this section:

28          (a) "Anesthesia or sedation provider" means an individual who is licensed:
29          (i) under Chapter 5a, Podiatric Physician Licensing Act;
30          (ii) under Subsection 58-31b-301(2)(e);
31          (iii) under Chapter 67, Utah Medical Practice Act;
32          (iv) under Chapter 68, Utah Osteopathic Medical Practice Act; or
33          (v) as a dentist under Chapter 69, Dentist and Dental Hygienist Practice Act, and who
34     has obtained the appropriate permit established by the division under Subsection 58-69-301(4).
35          (b) "Deep sedation" means a drug-induced depression of consciousness where an
36     individual:
37          (i) cannot be easily aroused;
38          (ii) responds purposefully following repeated or painful stimulation;
39          (iii) may not be able to independently maintain ventilatory function;
40          (iv) may require assistance in maintaining a patent airway; and
41          (v) usually maintains cardiovascular function.
42          (c) "General anesthesia" means a drug-induced loss of consciousness where an
43     individual:
44          (i) cannot be aroused, even by painful stimulation;
45          (ii) is often unable to maintain ventilatory function;
46          (iii) often requires assistance in maintaining a patent airway and positive pressure
47     ventilation may be required because of depressed spontaneous ventilation or drug-induced
48     depression of neuromuscular function; and
49          (iv) may not be able to maintain cardiovascular function.
50          (d) "General anesthetic" means a drug identified as a general anesthetic by the federal
51     Food and Drug Administration.
52          (e) "Minimal sedation" means a drug-induced state where an individual:
53          (i) responds normally to verbal commands;
54          (ii) may have reduced cognitive function and physical coordination; and
55          (iii) maintains airway reflexes, ventilatory function, and cardiovascular function.
56          (f) "Moderate sedation" means a drug-induced depression of consciousness where an
57     individual:
58          (i) responds purposefully to verbal commands, either alone or accompanied by light

59     tactile stimulation;
60          (ii) maintains a patent airway;
61          (iii) maintains spontaneous ventilation; and
62          (iv) usually maintains cardiovascular function.
63          (2) An anesthesia or sedation provider may not cause a patient to undergo moderate
64     sedation, deep sedation, or general anesthesia, in an outpatient setting that is not an emergency
65     department without:
66          (a) first providing the following information in writing and verbally:
67          (i) the level of anesthesia or sedation being administered;
68          (ii) the identity, type of license, and training of the provider who is performing the
69     procedure for which the anesthesia or sedation will be administered;
70          (iii) the identity, type of license, and a description of the training described in
71     Subsection (4) of the anesthesia or sedation provider who will be administering the anesthesia
72     or sedation; and
73          (iv) a description of the monitoring that will occur during the sedation or anesthesia,
74     including descriptions related to the monitoring of the patient's oxygenation, ventilation, and
75     circulation;
76          (b) after complying with Subsection (2)(a), obtaining the patient's written and verbal
77     consent regarding the procedure;
78          (c) having the training described in Subsection (4);
79          (d) directly supervising the patient;
80          (e) if the patient is a minor, having a current pediatric advanced life support
81     certification;
82          (f) if the patient is an adult, having a current advanced cardiovascular life support
83     certification;
84          (g) (i) having at least one individual in the procedure room who has advanced airway
85     training and the knowledge and skills to recognize and treat airway complications and rescue a
86     patient who entered a deeper than intended level of sedation; or
87          (ii) if the anesthesia or sedation provider is administering ketamine for a non-anesthetic
88     purpose, having at least one individual on site and available who has advanced airway training
89     and the knowledge and skills to recognize and treat airway complications and rescue a patient

90     who entered a deeper than intended level of sedation;
91          (h) having access during the procedure to an advanced cardiac life support crash cart in
92     the office with equipment that:
93          (i) is regularly maintained according to guidelines established by the American Heart
94     Association; and
95          (ii) includes:
96          (A) a defibrillator;
97          (B) administrable oxygen;
98          (C) age appropriate airway equipment;
99          (D) positive pressure ventilation equipment; and
100          (E) unexpired emergency and reversal medications including naloxone for opioid
101     sedation and flumazenil for benzodiazepine sedation;
102          (i) using monitors that meet basic standards set by the American Society of
103     Anesthesiologists and continually monitoring ventilatory function with capnography unless
104     precluded or invalidated by the nature of the patient, procedure, or equipment; and
105          (j) entering appropriate information into the patient's chart or medical record, which
106     shall include:
107          (i) the patient's name;
108          (ii) the route and site the anesthesia or sedation was administered;
109          (iii) the time of anesthesia or sedation administration and the dosage;
110          (iv) the patient's periodic vital signs during the procedure; and
111          (v) the name of the individual who monitored the patient's oxygenation and ventilation.
112          (3) (a) An anesthesia or sedation provider who violates Subsection (2) or any rule
113     created by the division to implement this section commits unprofessional conduct.
114          (b) An individual commits unprofessional conduct if the individual administers
115     anesthesia or sedation for which the individual is not appropriately trained.
116          (4) (a) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act,
117     the division shall make rules to create training and safety standards regarding the inducing of
118     general anesthesia, deep sedation, and moderate sedation:
119          (i) for each license described in Subsection (1)(a);
120          (ii) that are based on standards created by nationally recognized organizations, such as

121     the American Society of Anesthesiologists, the American Dental Association, or the American
122     Association of Oral and Maxillofacial Surgeons; and
123          (iii) that include safety standards for general anesthetic use that are consistent with
124     federal Food and Drug Administration guidance.
125          (b) For making rules described in Subsection (4)(a), the division shall consult with the
126     applicable licensing boards and a board described in Sections 58-67-201, 58-68-201, and
127     58-69-201.
128          (5) The requirements of Subsection (2) do not apply to the practice of inducing
129     minimal sedation.
130          (6) An employer may not take an adverse employment action against an employee if:
131          (a) the employee notifies the division of:
132          (i) a violation of this section; or
133          (ii) a violation of any rule created by the division to implement this section; and
134          (b) the employment action is based on the individual notifying the division of the
135     violation.