<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".09" citation="COMAR 10.44.12.09" title_num="10" subtitle_num="44" chapter_num="12" heading="Administration Evaluation.">
  <paragraph num="A.">
    <text>Class I Permit. To qualify for a Class I permit, the dentist who will perform the administration shall pass:</text>
    <paragraph num="(1)">
      <text>An office inspection evaluation;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>A clinical evaluation consistent with the age level of the patients treated by the dentist;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>An evaluation of the dentist to safely administer sedation techniques; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>An evaluation of the ability of the dentist to effectively respond to sedation related emergencies.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>The clinical evaluation required in §A of this regulation shall require the participation of the office staff.</text>
  </paragraph>
  <paragraph num="C.">
    <text>The clinical evaluation required by §A(2) of this regulation shall include evaluating treatment of at least the following:</text>
    <paragraph num="(1)">
      <text>Laryngospasm;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Foreign body airway obstruction;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Emergency airway management;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Emesis and aspiration;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Acute allergic reaction;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Bronchospasm;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Angina;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Conditions requiring advanced cardiac life support, including:</text>
      <paragraph num="(a)">
        <text>Bradycardia;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Tachycardia;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Ventricular fibrillation; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Cardiac arrest;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(9)">
      <text>Hypotension;</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Hypoglycemia;</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Hypertension;</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Seizure; and</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Syncope.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Class II or Class III Permit.</text>
    <paragraph num="(1)">
      <text>To qualify for a Class II or Class III permit, the dentist who will perform the administration shall pass an administration evaluation that consists of an office inspection and clinical evaluation.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The clinical evaluation required by §D(1) of this regulation shall:</text>
      <paragraph num="(a)">
        <text>Require the participation of the clinical office staff; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Evaluate the technical competency of the dentist to:</text>
        <paragraph num="(i)">
          <text>Safely administer moderate parenteral sedation, deep sedation, or general anesthesia; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Effectively respond to anesthesia related emergencies.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>The clinical evaluation required by §D(1) of this regulation shall include evaluating the treatment of at least the following:</text>
    <paragraph num="(1)">
      <text>Laryngospasm;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Foreign body airway obstruction;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Emergency airway management;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Emesis and aspiration;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Acute allergic reaction;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Bronchospasm;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Angina;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Conditions requiring advanced cardiac life support, including:</text>
      <paragraph num="(a)">
        <text>Bradycardia;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Tachycardia;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Ventricular fibrillation; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Cardiac arrest;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(9)">
      <text>Hypotension;</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Hypoglycemia;</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Hypertension;</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Seizure;</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Syncope; and</text>
    </paragraph>
    <paragraph num="(14)">
      <text>Venipuncture complications.</text>
    </paragraph>
  </paragraph>
</regulation>