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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 54 Pa.B. 1806 (March 30, 2024).

49 Pa. Code § 21.17. Anesthesia.

§ 21.17. Anesthesia.

 The administration of anesthesia is a proper function of a registered nurse and is a function regulated by this section; this function may not be performed unless:

   (1)  The registered nurse has successfully completed the educational program of a school for nurse anesthetists accredited by the Council on Accreditation of Education Programs of Nurse Anesthesia of the American Association of Nurse Anesthetists.

   (2)  The registered nurse is certified as a Registered Nurse Anesthetist by the Council on Certification or on Recertification of Nurse Anesthetists of the American Association of Nurse Anesthetists.

   (3)  The certified nurse anesthetist is authorized to administer anesthesia in cooperation with a surgeon or dentist. The nurse anesthetist’s performance shall be under the overall direction of the chief or director of anesthesia services. In situations or health care delivery facilities where these services are not mandatory, the nurse anesthetist’s performance shall be under the overall direction of the surgeon or dentist responsible for the patient’s care.

   (4)  Except as otherwise provided in 28 Pa. Code §  123.7(c) (relating to dental anesthetist and nurse anesthetist qualifications), when the operating/anesthesia team consists entirely of nonphysicians, such as a dentist and a certified registered nurse anesthetist, the registered nurse anesthetist shall have available to her by physical presence or electronic communication an anesthesiologist or consulting physician of her choice.

   (5)  A noncertified registered nurse who has completed an approved anesthesia program may administer anesthesia under the direction of and in the presence of the chief or director anesthesia services or a Board certified anesthesiologist until the announcement of results of the first examination given for certification for which she is eligible. If a person fails to take or fails to pass the examination, the person shall immediately cease practicing as a nurse anesthetist. If the applicant, due to extenuating circumstances, cannot take the first scheduled examination following completion of the program, the applicant shall appeal to the Board for authority to continue practicing.

 (b)  For purposes of this section, ‘‘cooperation’’ means a process in which the nurse anesthetist and the surgeon work together with each contributing an area of expertise, at their individual and respective levels of education and training.


   The provisions of this §  21.17 adopted October 22, 1976, effective October 23, 1976, 6 Pa.B. 2677; amended September 16, 1983, effective September 17, 1983, 13 Pa.B. 2827. Immediately preceding text appears at serial page (81100).

Cross References

   This section cited in 49 Pa. Code §  21.803 (relating to applicability of rules relating to professional nurses).

Notes of Decisions

   Willful Violation

   The provisions of 49 Pa. Code §  21.17 (relating to anesthesia) are wilfully violated even though a physician is present at the time the anesthetic is administered if the nurse administers the anesthetic without the physician’s direction or awareness. McCarl v. State Board of Nurse Examiners, 396 A.2d 866 (Pa. Cmwlth. 1979).

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