(a) An anesthesiologist assistant may assist an anesthesiologist in developing and implementing an anesthesia care plan for a patient. In providing assistance to an anesthesiologist, an anesthesiologist assistant may perform duties established by rule by the Board in any of the following functions that are included in the anesthesiologist assistant’s protocol while under the direct supervision of an anesthesiologist:

(1) Obtain a comprehensive patient history and present the history to the supervising anesthesiologist.

(2) Pretest and calibrate anesthesia delivery systems and monitor, obtain, and interpret information from the systems and monitors.

(3) Assist the supervising anesthesiologist with the implementation of medically accepted monitoring techniques.

(4) Establish basic and advanced airway interventions, including intubation of the trachea and performing ventilatory support.

132

COL 6/21/2023

10 Guam Code Ann. HEALTH AND SAFETY
CH. 12 MEDICAL PRACTICES

(5) Administer intermittent vasoactive drugs and start and adjust vasoactive infusions.

(6) Administer anesthetic drugs, adjuvant drugs, and accessory drugs.

(7) Assist the supervising anesthesiologist with the performance of epidural anesthetic procedures and spinal anesthetic procedures.

(8) Administer blood, blood products, and supportive fluids.

(9) Support life functions during anesthesia health care, including induction and intubation procedures, the use of appropriate mechanical supportive devices, and the management of fluid, electrolyte, and blood component balances.

(10) Recognize and take appropriate corrective action for abnormal patient responses to anesthesia, adjunctive medication, or other forms of therapy.

(11) Participate in management of the patient while in the post-anesthesia recovery area, including the administration of any supporting fluids or drugs.

(12) Perform other tasks not prohibited by law that are delegated by the supervising licensed anesthesiologist, and for which the anesthesiologist assistant has been trained and is proficient to perform.

(b) Nothing in this Section or Chapter shall prevent third- party payors from reimbursing employers of anesthesiologist assistants for covered services rendered by such anesthesiologist assistants.

(c) An anesthesiologist assistant must clearly convey to the patient that he or she is an anesthesiologist assistant.

(d) An anesthesiologist assistant may perform anesthesia tasks and services within the framework of a written practice protocol developed between the supervising anesthesiologist and the anesthesiologist assistant.

133

COL 6/21/2023

10 Guam Code Ann. HEALTH AND SAFETY
CH. 12 MEDICAL PRACTICES

(e) An anesthesiologist assistant may not prescribe, order, or compound any controlled substance, legend drug, or medical device, nor may an anesthesiologist assistant dispense sample drugs to patients. Nothing in this Section prohibits an anesthesiologist assistant from administering legend drugs or controlled substances; intravenous drugs, fluids, or blood products; or inhalation or other anesthetic agents to patients which are ordered by the supervising anesthesiologist and administered while under the direct supervision of the supervising anesthesiologist.

(f) An anesthesiologist assistant shall not administer or monitor general or regional anesthesia unless the supervising anesthesiologist:

(1) is physically present in the room during induction and emergence;

(2) is not concurrently performing any other anesthesiology procedure independently upon another patient; and

(3) is available to provide immediate physical presence in the room.

§ 122410. Registration of Anesthesiologist Assistant
Supervision.

Prior to practicing on Guam, the anesthesiologist assistant shall present for approval of the Board of Medical Examiners a completed application for supervision by a Guam-licensed anesthesiologist. The practice of the anesthesiologist assistant must fall within the practice of the supervising anesthesiologist with whom the anesthesiologist assistant is registered. In the event of any changes of a supervising anesthesiologist, the names of the supervising anesthesiologists must be provided to the Board. The Board must be notified at least ten (10) days prior to the effective date of change. Practicing without a supervising anesthesiologist shall be grounds for disciplinary action, including revocation of license.

134

COL 6/21/2023

10 Guam Code Ann. HEALTH AND SAFETY
CH. 12 MEDICAL PRACTICES