NAC634.3665. Requirements to perform manipulation on patient under anesthesia.

     1. A licensee shall not perform manipulation on a patient under anesthesia unless the licensee performs the manipulation at a medical facility or office described in subsection 2 and:

     (a) Has obtained certification to perform such manipulation from:

          (1) A college of chiropractic that is accredited by the Council on Chiropractic Education; or

          (2) Another program approved by the Board; or

     (b) Is enrolled in a program to obtain the certification described in paragraph (a) at the time the manipulation is performed and the licensee performs the manipulation under the direct supervision of a qualified instructor approved by the Board.

     2. The manipulation described in subsection 1 may be performed:

     (a) On a patient who is under general anesthesia or deep sedation, only in a hospital or surgical center for ambulatory patients that is licensed by the Health Division of the Department of Health and Human Services and accredited by:

          (1) The Joint Commission on Accreditation of Healthcare Organizations; or

          (2) The National Committee for Quality Assurance; or

     (b) On a patient who is under conscious sedation:

          (1) In a medical facility described in paragraph (a); or

          (2) In the office of a physician licensed pursuant to chapter 630 of NRS or osteopathic physician licensed pursuant to chapter 633 of NRS who is currently certified by a specialty board of the American Board of Medical Specialties in the specialty of anesthesiology, emergency medicine or the management of pain, if the office is approved by the Board for the administration, monitoring and control of conscious sedation by a licensee.

     3. As used in this section:

     (a) “Conscious sedation” means a minimally depressed level of consciousness, produced by a pharmacologic or nonpharmacologic method, or a combination thereof, in which the patient retains the ability independently and continuously to maintain an airway and to respond appropriately to physical stimulation and verbal commands.

     (b) “Deep sedation” means a controlled state of depressed consciousness, produced by a pharmacologic or nonpharmacologic method, or a combination thereof, and accompanied by a partial loss of protective reflexes and the inability to respond purposefully to verbal commands.

     (c) “General anesthesia” means a controlled state of unconsciousness, produced by a pharmacologic or nonpharmacologic method, or a combination thereof, and accompanied by partial or complete loss of protective reflexes and the inability independently to maintain an airway and respond purposefully to physical stimulation or verbal commands.

     (d) “Hospital” has the meaning ascribed to it in NRS 449.012.

     (e) “Surgical center for ambulatory patients” has the meaning ascribed to it in NRS 449.019.

     (Added to NAC by Chiropractic Physicians’ Bd. by R095-03, eff. 10-22-2003; A by R034-05, 10-31-2005)