Minimum Standards for In Office Patient Monitoring

The WSMA supports the implementation of the following minimum standards during all office-based procedures where moderate sedation is the lowest intended depth of anesthesia: 

1. Continuous oximetry monitoring 
2. Heart rate and rhythm monitoring 
3. Monitoring ventilatory function by direct observation and capnometry 
4. Non-invasive blood pressure monitoring 
5. Continuous EKG monitoring when deep sedation is the intended depth of anesthesia 
(Res B-1, A-25)
 
The WSMA urges contemporaneous recording of vital signs during all office-based procedures under moderate or deep sedation at the following times: 
1. Once before sedation, 
2. During sedation, at regular intervals not to exceed 5 minutes 
3. Post-operatively until the patient meets appropriate discharge criteria  
(Res B-1, A-25)
 
The WSMA supports the requirement that a BLS (at minimum) trained person who is not performing the procedure is actively monitoring and recording vital signs and is able to initiate a response to deviations from normal vital signs by alerting the proceduralist. (Res B-1, A-25)

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Abbreviations for House of Delegates report origination:

EC – Executive Committee; BT – Board of Trustees; CPA – Council on Professional Affairs; JC – Judicial Council; CHS – Community and Health Services