Sedation and General Anaesthesia News
Last updated: September 27, 2019
Important updates for registrants and facilities administering sedation and general anaesthesia
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 December 2016 addenda for Deep and GA related to qualifications for anaesthetists.
