<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".05" citation="COMAR 10.32.06.05" title_num="10" subtitle_num="32" chapter_num="06" heading="Scope of Practice.">
  <paragraph num="A.">
    <text>A licensed polysomnographic technologist may practice only under the supervision of a licensed physician.</text>
  </paragraph>
  <paragraph num="B.">
    <text>A licensed polysomnographic technologist may practice only in a hospital sleep laboratory or a stand-alone sleep center.</text>
  </paragraph>
  <paragraph num="C.">
    <text>The scope of practice of a licensed polysomnographic technologist includes and is limited to the following:</text>
    <paragraph num="(1)">
      <text>Monitoring and recording physiologic data during sleep, including sleep-related respiratory disturbances;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Using data collected under §C(1) of this regulation to assist a licensed physician in the diagnosis and treatment of sleep and wake disorders;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Assisting with the diagnosis and treatment of individuals who suffer from sleep disorders as a result of developmental defects, the aging process, physical injury, disease, or actual or anticipated somatic dysfunction;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Observing and monitoring physical signs and symptoms, general behavior, and general physical responses to polysomnographic evaluation, and determining whether initiation, modification, or discontinuation of a treatment regimen is warranted;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Using evaluation techniques that include limited cardiopulmonary function assessments, the need and effectiveness of therapeutic modalities and procedures, and the assessment and evaluation of the need for extended care; and</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Using the following techniques, equipment, and procedures:</text>
      <paragraph num="(a)">
        <text>Continuous positive airway pressure, bi-level positive airway pressure titration, or adaptive servo-ventilation on spontaneously breathing patients;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Supplemental low flow oxygen therapy during polysomnogram;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Capnography during polysomnogram;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Cardiopulmonary resuscitation;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Pulse oximetry;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>PH probe placement and monitoring;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Esophageal pressure;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Sleep staging, including surface electroencephalography, surface electrooculography, and surface submental electromyography;</text>
      </paragraph>
      <paragraph num="(i)">
        <text>Surface electromyography of arms and legs;</text>
      </paragraph>
      <paragraph num="(j)">
        <text>Electrocardiography;</text>
      </paragraph>
      <paragraph num="(k)">
        <text>Respiratory effort, including thoracic and abdominal;</text>
      </paragraph>
      <paragraph num="(l)">
        <text>Plethysmography blood flow;</text>
      </paragraph>
      <paragraph num="(m)">
        <text>Snore monitoring;</text>
      </paragraph>
      <paragraph num="(n)">
        <text>Audio or video monitoring;</text>
      </paragraph>
      <paragraph num="(o)">
        <text>Implementation of a written or verbal order from a licensed physician that requires the practice of polysomnography;</text>
      </paragraph>
      <paragraph num="(p)">
        <text>Monitoring the effects a nasal device used to treat sleep apnea has on sleep patterns provided that the device does not extend into the trachea; and</text>
      </paragraph>
      <paragraph num="(q)">
        <text>Monitoring the effects an oral device used to treat sleep apnea has on sleep patterns provided that:</text>
        <paragraph num="(i)">
          <text>The oral device does not extend into the trachea;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>A dentist has evaluated the structures of the patient's oral and maxillofacial region for purposes of fitting the oral device;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>A dentist made or directed the making of the oral device; and</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>A dentist directs the use of the oral device.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>The scope of practice of a polysomnographic technologist does not include administering medications.</text>
  </paragraph>
</regulation>