# COMAR Title 10 — Maryland Department of Health

## Subtitle 27 — Board of Nursing

### Chapter 06 — Practice of Nurse Anesthetist

#### Regulation .05 Scope of Practice.

*COMAR 10.27.06.05*

A. A nurse anesthetist may perform the following functions:

  (1) Perioperative assessment and management of patients requiring anesthesia services;

  (2) Administration of anesthetic agents;

  (3) Management of fluids in intravenous therapy;

  (4) Respiratory care; and

  (5) In accordance with §D of this regulation, prescribe, order, and administer drugs, including a drug that is classified as a controlled dangerous substance under Criminal Law Article, Title 5, Subtitle 4, Annotated Code of Maryland.

B. A nurse anesthetist has the right and obligation to refuse to perform a delegated act if, in the nurse anesthetist’s judgment, the act is:

  (1) Unsafe;

  (2) An invalidly prescribed medical act; or

  (3) Beyond the clinical skills of the nurse anesthetist.

C. Section A of this regulation may not be construed to authorize a nurse anesthetist to:

  (1) Diagnose a medical condition;

  (2) Provide care that is not consistent with the scope of practice of nurse anesthetists; or

  (3) Provide care for which the nurse anesthetist does not have proper education and experience.

D. A nurse anesthetist may prescribe drugs in accordance with §A of this regulation:

  (1) Only in an amount that does not exceed a 10-day supply;

  (2) Only for an individual with whom the nurse anesthetist has, at the time of prescription, established a client or patient record; and

  (3) Only in connection with the delivery of anesthesia services.