Chapter 4731-24 | Anesthesiologist Assistants

Rule 4731-24-01 | Definitions.

• Effective: July 31, 2019
• Promulgated Under: 119.03

As used in Chapter 4731-24 of the Administrative Code:

(A) "Administer" means to apply directly a drug, whether by injection, inhalation, ingestion, or any other means, and the infusion of blood, blood products and supportive fluids.

(B) "Assist" means to carry out procedures as requested by the supervising anesthesiologist, provided that the requested procedure is within the anesthesiologist assistant's training and scope of practice, is authorized by the practice protocol adopted by the supervising anesthesiologist, and is not prohibited by Chapter 4731. or 4760. of the Revised Code, or by any provision of agency 4731 of the Administrative Code.

(C) "Drug" has the same meaning as in division (E) of section 4729.01 of the Revised Code.

(D) "Direct supervision, and in the immediate presence of" means the following:

(1) The supervising anesthesiologist shall remain physically present and available for immediate diagnosis and treatment of emergencies;

(2) The supervising anesthesiologist shall be physically present in the anesthetizing area or operating suite, as defined by the hospital or ambulatory surgical facility, and accessible by page, telephone, or overhead page, such that he or she is immediately available to participate directly in the care of the patient with whom the anesthesiologist assistant and the supervising anesthesiologist are jointly involved;

(3) The supervising anesthesiologist shall personally participate in the most demanding procedures in the anesthesia plan, which shall include induction and emergence; and

(4) "Direct supervision and the in immediate presence of" shall not be interpretted to:

(a) Require the supervising anesthesiologist's presence in the same room as the anesthesiologist assistant for the duration of the anesthetic management; or

(b) Prohibit the supervising anesthesiologist from addressing an emergency of short duration, administering labor analgesia, or performing duties of short duration as required of a perioperative specialist in another location in the hospital or ambulatory surgical facilty.

Supplemental Information

Authorized By: 4760.08, 4760.19
Amplifies: 4760.08, 4760.09
Five Year Review Date: 7/31/2024

Rule 4731-24-02 | Anesthesiologist assistants: supervision.

• Effective: July 31, 2019
• Promulgated Under: 119.03

(A) A supervising anesthesiologist shall supervise an anesthesiologist assistant within the terms, conditions, and limitations set forth in a written practice protocol that is consistent with section 4760.08 of the Revised Code and this chapter of the Administrative Code. The supervision shall be direct supervision and in the immediate presence of the anesthesiologist assistant, as that term is defined in rule 4731-24-01 of the Administrative Code.

(B) An anesthesiologist assistant shall only perform those tasks assigned on a case-by-case basis by the supervising anesthesiologist. The anesthesiologist assistant shall implement the personalized plan for a patient as individually prescribed by the supervising anesthesiologist after the physician has completed a specific assessment of the patient.

(C) In determining which anesthetic procedures to assign to an anesthesiologist assistant, a supervising anesthesiologist shall consider all of the following:

(1) The education, training, and experience of the anesthesiologist assistant;

(2) The anesthesiologist assistant's scope of practice as defined in section 4760.09 of the Revised Code and this chapter of the Administrative Code;

(3) The conditions on the practice of the anesthesiologist assistant set out in the written practice protocol;

(4) The physical status of the patient according to the physical status classification system of the American society of anesthesiologists, as in effect at the time the assignment of procedures is made. The classification system is available from the American society of anesthesiologists and shall be posted on the board's website at med.ohio.gov.

(5) The invasiveness of the anesthetic procedure;

(6) The level of risk of the anesthetic procedure;

(7) The incidence of complications of the anesthetic procedure;

(8) The physical proximity of the supervising anesthesiologist and the anesthologist assistant or assistants being supervised concurrently; and

(9) The number of patients whose care is being supervised concurrently by the supervising anesthesiologist.

(D) During the first four years of an anesthesiologist assistant's practice, the supervising anesthesiologist shall provide enhanced supervision as defined in this chapter of the Administrative Code.

(E) The supervising anesthesiologist shall retain responsibility for the anesthetic management in which the anesthesiologist assistant has participated.

Supplemental Information

Authorized By: 4760.08, 4760.19
Amplifies: 4731.22, 4760.08, 4760.09
Five Year Review Date: 7/31/2024
Prior Effective Dates: 5/30/2003

Rule 4731-24-03 | Anesthesiologist assistants: enhanced supervision.

• Effective: July 31, 2019
• Promulgated Under: 119.03

(A) A supervising anesthesiologist shall provide enhanced supervision of an anesthesiologist assistant during the first four years of the anesthesiologist assistant's practice.

(B) "Enhanced supervision" means the following:

(1) The supervising anesthesiologist shall require regular, documented quality assurance interactions between the supervising anesthesiologist and the anesthesiologist assistant .

(a) The regularly scheduled quality assurance interactions shall occur in greater number and with greater frequency during the first four years of an anesthesiologist assistant's practice than would be required for quality assurance purposes for anesthesiologist assistants in practice for more than four years and shall take place no less frequently than once every three months.

(b) The anesthesiologist assistant shall be required to file on a monthly basis during the first two years of practice a separate record of the cases of anesthetic management in which he or she participated. The record shall be reviewed by a supervising anesthesiologist as a component of the quality assurance interactions.

(c) The reviewing supervising anesthesiologist shall file a report of each quality assurance interaction with the appropriate committee.

(2) The supervising anesthesiologist shall make direct observations of the anesthesiologist assistant during the course of each case of anesthetic management.

(a) During the first year of an anesthesiologist assistant's practice, the direct observations of each case of anesthetic management shall be made more frequently than for comparable procedures for anesthesiologist assistants practicing beyond their first year, and include direct observation of induction and emergence.

(b) The supervising anesthesiologist shall document the enhanced supervision in the anesthetic record.

(3) The period of enhanced supervision for an anesthesiologist assistant who has practiced in another state prior to beginning practice in Ohio shall be determined as follows:

(a) The anesthesiologist assistant shall be given credit for the time practiced in another state.

(b) The credit shall be on a year-for-year basis, except that the supervising anesthesiologist shall provide enhanced supervision as defined in this rule for the first three months of the anesthesiologist assistant's practice in Ohio.

Supplemental Information

Authorized By: 4760.08, 4760.19
Amplifies: 4760.08
Five Year Review Date: 7/31/2024
Prior Effective Dates: 5/30/2003