2025 -- S 0694
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LC002337
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S T A T E O F R H O D E I S L A N D
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2025
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A N A C T
RELATING TO BUSINESSES AND PROFESSIONS -- NURSES
Introduced By: Senators Ciccone, Bissaillon, Felag, LaMountain, and Tikoian
Date Introduced: March 07, 2025
Referred To: Senate Health & Human Services
It is enacted by the General Assembly as follows:
SECTION 1. Chapter 5-34 of the General Laws entitled "Nurses" is hereby amended by 1
adding thereto the following section: 2
5-34-3.1. Safe administration of sedation. 3
(a) Registered nurses (RNs) and advanced practice registered nurses (APRNs), other than 4
licensed certified registered nurse anesthetists (CRNAs), as defined in this chapter, and RNs 5
enrolled in a nurse anesthesiology training program approved by the Council on Accreditation of 6
Nurse Anesthesia Educational programs (COA) or its predecessors or successors, shall not 7
administer agents that are primarily used and classified as general anesthetics for minimal, 8
moderate, deep sedation, or general anesthesia including, propofol, Etomidate, sodium thiopental, 9
methohexital, or volatile gases (e.g. sevoflurane, isoflurane, desflurane), nor shall any RN or Non-10
CRNA APRN administer or manage deep sedation or general anesthesia for any diagnostic, 11
therapeutic, or surgical procedures using any drug or medication. 12
(b) For critical life-saving situations requiring the immediate and emergent facilitation of 13
airway management (rapid sequence intubation) or to maintain sedation for tracheally intubated 14
and mechanically ventilated patients, an RN acting as the third hand of a licensed APRN or 15
physician, or an APRN may initiate, titrate, and bolus intravenous/intraosseous (IV/IO) agents. An 16
APRN, may initiate, titrate, and bolus intravenous/intraosseous (IV/IO) agents if the APRN is 17
trained in airway management and acting within their scope of practice and approved by their 18
governing body, as authorized in this section. 19
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(c) For emergency situations where there is an imminent threat to life or limb, the APRN 1
or RN can administer anesthetic medications to preserve patient life including, but not limited to, 2
cardiac arrest, respiratory failure, and increased intracranial pressure, acting within their scope of 3
practice and approved by their governing body. 4
(d) Nothing in this section shall prohibit the administration and/or titration of anesthetics 5
for patients being sedated in a critical care setting (emergency room, intensive care unit) and are 6
tracheally intubated, and mechanically ventilated by a RN or APRN acting within the scope of 7
practice and approved by their governing body. 8
SECTION 2. Chapter 5-34.2 of the General Laws entitled "Nurse Anesthetists" is hereby 9
amended by adding thereto the following section: 10
5-34.2-2.1. Safe administration of sedation. 11
(a) Registered nurses (RNs) and advanced practice registered nurses (APRNs), other than 12
licensed certified registered nurse anesthetists (CRNAs), as defined in this chapter, and RNs 13
enrolled in a nurse anesthesiology training program approved by the Council on Accreditation of 14
Nurse Anesthesia Educational programs (COA) or its predecessors or successors, shall not 15
administer agents that are primarily used and classified as general anesthetics for minimal, 16
moderate, deep sedation, or general anesthesia including, propofol, Etomidate, sodium thiopental, 17
methohexital, or volatile gases (e.g. sevoflurane, isoflurane, desflurane), nor shall any RN or Non-18
CRNA APRN administer or manage deep sedation or general anesthesia for any diagnostic, 19
therapeutic, or surgical procedures using any drug or medication. 20
(b) For critical life-saving situations requiring the immediate and emergent facilitation of 21
airway management (rapid sequence intubation) or to maintain sedation for tracheally intubated 22
and mechanically ventilated patients, an RN acting as the third hand of a licensed APRN or 23
physician, or an APRN may initiate, titrate, and bolus intravenous/intraosseous (IV/IO) agents. An 24
APRN, may initiate, titrate, and bolus intravenous/intraosseous (IV/IO) agents if the APRN is 25
trained in airway management and acting within their scope of practice and approved by their 26
governing body, as authorized in this section. 27
(c) For emergency situations where there is an imminent threat to life or limb, the APRN 28
or RN can administer anesthetic medications to preserve patient life including, but not limited to, 29
cardiac arrest, respiratory failure, and increased intracranial pressure, acting within their scope of 30
practice and approved by their governing body. 31
(d) Nothing in this section shall prohibit the administration and/or titration of anesthetics 32
for patients being sedated in a critical care setting (emergency room, intensive care unit) and are 33
tracheally intubated, and mechanically ventilated by a RN or APRN acting within the scope of 34
LC002337 - Page 3 of 4
practice and approved by their governing body. 1
SECTION 3. This act shall take effect upon passage. 2
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO BUSINESSES AND PROFESSIONS -- NURSES
***
This act would establish that the elective and/or independent administration of propofol, 1
Etomidate, sodium thiopental, methohexital, and volatile anesthetics for any surgery or procedure 2
is not, generally, within the “scope of practice” of registered nurses and non-CRNA advance 3
practice registered nurses as defined in chapter 34.3 of title 5 and would restrict the administration 4
of these medications to licensed certified registered nurse anesthetists. It would also detail each of 5
those limited emergency circumstances where a registered nurse and advanced practice registered 6
nurses, may safely administer sedation, such as critical life-saving or emergency situations where 7
there is an imminent threat to life or limb. This act would detail each of those limited emergency 8
circumstances where registered nurses and advanced practice registered nurses, may safely 9
administer sedation, such as critical life-saving or emergency situations where there is an imminent 10
threat to life or limb. 11
This act would take effect upon passage. 12
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