Florida Board of Medicine Declaratory Statement on AAs Performing Epidurals

November 8, 2017

The Florida Board of Medicine issued a Declaratory Statement on November 8, 2017 on whether an anesthesiologist assistant (AA) can perform epidural anesthetic procedures and spinal anesthetic procedures. The AA statute [section 458.3475(3)(a), Florida Statutes] states that AAs can “assist” the supervising anesthesiologist with the performance of epidural anesthetic procedures and spinal anesthetic procedures.

The Declaratory Statement concludes that the term “assist” as used in the AA statute allows an AA to perform epidural anesthetic procedures and spinal anesthetic procedures under the following conditions:

a. The supervising anesthesiologist must personally examine each and every patient and order the medication to be administered.
b. The supervising anesthesiologist must directly supervise the administration of the medication by remaining in the same room as the AA performing the procedure.
c. The supervising anesthesiologist must verify the training and capability of the AA to provide such services.
d. These conditions must be included in the AA’s protocol filed by the supervising anesthesiologist in accordance with the AA statute.

The Board of Medicine rejected a similar declaratory statement petition in 2015. The 2015 petition differed in that it did not require the anesthesiologist to remain in the same room during the procedure. The Board concluded that under those circumstances an AA performing epidural anesthetic procedures and spinal anesthetic procedures was not “assisting”.

Although a declaratory statement applies only to the individual requesting it, such statements are an indicator of how the Board would apply its laws and rules to another practitioner under identical circumstances. If another practitioner’s circumstances differ even slightly from those of the petitioner, the declaratory statement cannot be relied on in any way. Based on the Board’s rulings on this issue, it is clear that the presence of the supervising anesthesiologist in the same room as the AA is required in order for an AA to perform epidural and spinal anesthetic procedures; and if the supervising anesthesiologist is not present in the same room as the AA, the procedures would not be allowed.

Click Here For Declaratory Statement

Glenn E. Thomas
FANA Legal Counsel