Sedation and General Anaesthesia News

CDSBC is seeking ways to reduce barriers to our registrants and support the need for physical distancing in order to prevent the transmission of COVID-19. The following announcement applies to sedation providers and to deep sedation and general anaesthetic service facilities.

We recognize that some regulatory processes and requirements for sedation and general anaesthesia may be difficult, or even impossible, to accomplish at this time. The following changes are intended to provide additional flexibility. We request that all documents be submitted electronically in order to avoid unnecessary delay.  

In-office Assessments

All in-office assessments for deep sedation and general anaesthetic service facilities are being postponed. Rescheduling will begin July 2, 2020 at the earliest.

If your office is currently scheduled for in-office assessment between April 21 and June 30, 2020, we will contact you to reschedule.

Facilities with expiring Confirmation of Compliance between March 18 and July 1, 2020 will all be granted an extension until July 2, 2020. The College will contact individual facility owners for extensions as required; considerations for extension will be reviewed on a case-by-case basis.

Fees will be deferred until in-office assessments are scheduled.
 

Annual Self-assessments

All facilities with annual self-assessments due between March 18 and July 1, 2020 are being granted extensions to July 2, 2020.

If your self-assessment is complete, please send it by email using a password-protected PDF to Ruby Ma, Sedation Program Coordinator, at rma@cdsbc.org.
 

In-person Courses

In-person course work that does not align with the overarching social distancing expectations may be deferred until June 30, 2020. If you are unable to renew by June 30, please email rma@cdsbc.org to request a further extension. Cases will be reviewed on an individual basis. Courses that may need to be deferred due to the in-person components include Basic Life Support, Advanced Cardiovascular Life Support, Pediatric Advanced Life Support and the Difficult Airway Course.
 

Registration of Qualifications

Registrants who wish to register for moderate sedation, deep sedation, or general anesthesia are asked to email their application package in the form of a password-protected PDF to Ruby Ma, Sedation Program Coordinator, at rma@cdsbc.org.

If you have questions about these changes, please contact the CDSBC Sedation Program Coordinator, Ruby Ma, at rma@cdsbc.org.

The changes described here have been approved by the Sedation and General Anaesthetic Services Committee.  

Further to our September 27 communication to registrants, clinical staff who are part of the sedation and/or general anaesthetic team are required to have current Basic Life Support (BLS) level certification  

CDSBC's expectation is that clinical staff on the sedation team hold current BLS certification as defined by the course provider. It is up to the registrant to determine whether the course meets CDBSC's requirements (see below) and that your certification is valid.  

We recognize that there is a broad range of BLS course content and the course offerings are not consistent among providers. To provide clarity, the College will accept any BLS course that is designed for healthcare professionals, and that:  

• Includes bag-valve-mask training (airway management)
• Has a hands-on component (courses entirely online are not acceptable)
• Has a certification length of not longer than 24 months

Note that CPR Level C is not acceptable for sedation and/or general anaesthesia clinical staff.
 

If you are uncertain about the validity of your certification, we recommend contacting your training provider.  

Please note that the related standards and guidance documents will be updated in the coming months to reflect all of these changes.  

*Basic Life Support (BLS) level certification replaces the previous CPR-HCP (Health Care Provider) requirement.  

Questions? Contact Ruby Ma, Sedation Program Coordinator, at sedation@cdsbc.org
 

If you or your dental facility currently administers minimal, oral or parenteral moderate, deep sedation or general anesthesia, please ensure you read the following updates and ensure you understand how they relate to your practice.  

Board-approved updates

A number of updates were approved by the CDSBC Board. The related standards and guidance documents will be updated in the coming months to reflect all of these changes. In the meantime registrants should refer to the following for the most up-to-date guidance.  

Moratorium on the approval of pediatric moderate sedation certification

Registrants may only administer moderate sedation (both oral and parenteral) to patients who are 12 years of age and under in out-of-hospital dental facilities when they:  

• are qualified and authorized to provide deep sedation and/or general anaesthesia, or
• have completed training in a formal postgraduate program in pediatric dentistry that meets CDSBC Standards.

Practitioners who do not fall under these categories must cease provision of moderate sedation services to patients 12 years of age and younger within three months of the day of this notice (i.e. by December 27, 2019).  

Registrants who do not meet the specific requirements but wish to provide moderate sedation to patients 12 years old and younger may submit their Registration of Qualifications for the Sedation & General Anaesthetic Services Committee’s consideration.  

Revised criteria for moderate sedation mentors

Parenteral sedation cases are now accepted towards the 150-case requirement for mentors who wish to provide mentorship for moderate sedation utilizing multiple oral sedative drugs (with or without nitrous oxide/oxygen).  

Basic Life Support (BLS) replaces previous CPR-HCP requirement

Clinical staff who are part of the sedation and/or general anaesthetic team are required to have current Basic Life Support (BLS) level certification, replacing the previous CPR-HCP requirement. The BLS course must include bag valve mask training. Per Heart & Stroke Foundation and Red Cross, annual retraining is required to maintain currency.  

Current certificates with a 2-year expiry date are acceptable until January 1, 2020.  

Essential drug lists revised / epinephrine dosage formatting updated

• Essential drug lists for deep sedation and general anaesthesia have been updated, and "highly recommend drugs" have been removed.
• References to epinephrine dosages have also been updated in accordance with the Institute for Safe Medication Practices (ISMP) Canada's format recommendations. These changes are now reflected in the published online documents for Deep Sedation Services in Dentistry and General Anaesthetic Services in Dentistry. The Minimal and Moderate Sedation Services document will be updated to reflect the ISMP Canada format recommendation for epinephrine dosage in the coming months.

Maintenance and inspection frequency for nitrous oxide/oxygen equipment and addition of AED

Automated external defibrillator (AED) has been added to the minimum requirements for airway management and equipment in offices that provide moderate sedation, deep sedation, and general anaesthesia.  

Nitrous oxide/oxygen equipment must have an appropriate scavenging system and be active whenever the equipment is in use.  

Updated Addendum

A correction has been made to the second paragraph under Practitioner Administering Deep Sedation / GA (Qualifications) December 2016 addenda for Deep and GA.  

• Corrected December 2016 addendum for Deep Sedation Services in Dentistry (PDF)
• Corrected December 2016 addendum for General Anaesthetic Services in Dentistry (PDF)