Florida Board of Dentistry Vote Requiring Supervision of a Qualified Anesthetist Confirms FSA's Call for Patient Safety

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The Florida Board of Dentistry (BOD) ruled unanimously last week that CRNAs would be prohibited from sedating patients to a level deeper than the sedation permit held by the dentist. Current Florida law requires that a physician or dentist administer or supervise such sedation.

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'Our organization anticipates that FANA will continue to probe the health system for opportunities in which to expand their scope of practice and we will remain vigilant to maintain the safety of our patients,' said Jay Epstein, M.D., FSA President.

The Florida Board of Dentistry (BOD) ruled unanimously last week that CRNAs would be prohibited from sedating patients to a level deeper than the sedation permit held by the dentist. Current Florida law requires that a physician or dentist administer or supervise such sedation.

After hearing testimony from the Florida Association of Nurse Anesthetists (FANA), the Florida Society of Anesthesiologists and the Florida Dental Association (FDA), the Board rejected the argument that nurse anesthetists were as safe as anesthesiology physicians and could therefore sedate patients to a level deeper than the training of their supervising dentist. The Board ruled this past spring that anesthesiologists, by virtue of their education and training, could sedate dental patients to whatever level deemed necessary and safe by the physician and dentist.

The Board of Dentistry did not agree that access to care would become limited and costs for anesthesia would increase if nurse anesthetists were not allowed to expand their scope of practice, as argued by FANA’s attorney.

The Florida Society of Anesthesiologists maintains the position that in order to provide the highest quality of care, patients should have the same vital protection when they undergo surgery in a medical or dental office as they do in hospitals and ambulatory surgical centers. “Our organization anticipates that FANA will continue to probe the health system for opportunities in which to expand their scope of practice and we will remain vigilant to maintain the safety of our patients,” said Jay Epstein, M.D., FSA President.

Peer-reviewed scientific have clearly shown that when anesthesiologists are involved in direct patient care or lead the anesthesia care team, patient outcomes are superior and complications rates are lower (1). Having an anesthesiologist involved, as one such study demonstrated, meant that there were seven fewer deaths for every 10,000 patients put to sleep (2).

Anesthesiologists receive a medical education that is twice as long as that of nurse anesthetists, equating to 10,000 to 14,000 hours of clinical training versus 1,000 to 2,500 hours for the CRNAs. FSA’s position is that while nurse anesthetists are well-respected and highly regarded members of the anesthesia-care team, their level of training and experience — critical elements in the highly complicated areas of anesthesia, intensive care and interventional pain medicine —is not equivalent to that attained by an anesthesiology physician.

About the Florida Society of Anesthesiologists
The Florida Society of Anesthesiologists upholds the highest standards of anesthesia care and patient advocacy by promoting research, education, and innovation. FSA’s principals are rooted in the preservation of patient safety for all Floridians undergoing surgical, obstetric, or invasive procedures. For more information about the society, please visit http://www.fsahq.org.

1. The Scope of Practice of Nurse Anesthetists; American Society of Anesthesiologists , January 2004
2. Anesthesiologist Direction and Patient Outcomes; Silber, Jeffrey H. M.D., Ph.D.; The Journal of the American Society of Anesthesiologists, Inc., July 2000.

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