<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".05" citation="COMAR 10.27.06.05" title_num="10" subtitle_num="27" chapter_num="06" heading="Scope of Practice.">
  <paragraph num="A.">
    <text>A nurse anesthetist may perform the following functions:</text>
    <paragraph num="(1)">
      <text>Perioperative assessment and management of patients requiring anesthesia services;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Administration of anesthetic agents;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Management of fluids in intravenous therapy;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Respiratory care; and</text>
    </paragraph>
    <paragraph num="(5)">
      <text>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.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>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:</text>
    <paragraph num="(1)">
      <text>Unsafe;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>An invalidly prescribed medical act; or</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Beyond the clinical skills of the nurse anesthetist.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Section A of this regulation may not be construed to authorize a nurse anesthetist to:</text>
    <paragraph num="(1)">
      <text>Diagnose a medical condition;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Provide care that is not consistent with the scope of practice of nurse anesthetists; or</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Provide care for which the nurse anesthetist does not have proper education and experience.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>A nurse anesthetist may prescribe drugs in accordance with §A of this regulation:</text>
    <paragraph num="(1)">
      <text>Only in an amount that does not exceed a 10-day supply;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Only for an individual with whom the nurse anesthetist has, at the time of prescription, established a client or patient record; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Only in connection with the delivery of anesthesia services.</text>
    </paragraph>
  </paragraph>
</regulation>