WSR 07-10-120

PROPOSED RULES

DEPARTMENT OF HEALTH


(Veterinary Board of Governors)

[ Filed May 2, 2007, 9:36 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 05-24-113.

Title of Rule and Other Identifying Information: WAC 246-935-050 Animal health care tasks for veterinary technicians.

Hearing Location(s): Department of Health, Center Point Corporate Park, 20435 72nd Avenue South, Conference Room Two, Kent, WA 98032, on June 11, 2007, at 10:00 a.m.

Date of Intended Adoption: June 11, 2007.

Submit Written Comments to: Judy Haenke, Program Manager, P.O. Box 47868, Olympia, WA 98504-7868, web site http://www3.doh.wa.gov/policyreview/, fax (360) 586-4359, by June 4, 2007.

Assistance for Persons with Disabilities: Contact Judy Haenke by June 4, 2007, TTY (800) 833-6388 or 711.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The amended rule will allow, but not require, a registered veterinary technician to close an incision or prepared wound as directed by a licensed veterinarian under direct supervision. By directing the veterinary technician to close an incision or prepared wound, the veterinarian can attend to other patients. It is anticipated that there will be more review and revision of this section in the future.

Reasons Supporting Proposal: The proposed amendment is the outcome of a rule-making petition from the Washington state association of veterinary technicians and consideration by the veterinary board of governors of standards necessary to protect the health of animal patients in Washington state. Initially, the board intended to review and update the entire section. At this time, in response to the petition, the board is moving forward only with the approval and definition of suturing. It is anticipated that the rule will be opened again at a later date under a separate CR-101 (preproposal notice) to complete the review.

Statutory Authority for Adoption: RCW 18.92.030.

Statute Being Implemented: RCW 18.92.030.

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: Department of health, veterinary board of governors, governmental.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Judy Haenke, Program Manager, P.O. Box 47868, Olympia, WA 98504-7868, (360) 236-4947.

No small business economic impact statement has been prepared under chapter 19.85 RCW. No small business economic impact statement has been prepared under RCW 19.85.030(1) because the proposed rule does not impose more than minor costs on businesses within the industry.

A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Judy Haenke, Program Manager, P.O. Box 47868, Olympia, WA 98504-7868, phone (360) 236-4947, fax (360) 586-4359, e-mail judy.haenke@doh.wa.gov.

April 26, 2007

Lisa Salmi

Acting Executive Director

OTS-9468.2


AMENDATORY SECTION(Amending WSR 02-02-046, filed 12/27/01, effective 1/27/02)

WAC 246-935-050   Animal health care tasks.   (1) Veterinary technicians.

No individual, other than a registered veterinary technician, may advertise or offer her/his services in a manner calculated to lead others to believe that she/he is a trained or registered veterinary technician.

Veterinary technicians are prohibited from performing the following activities: Surgery except as outlined below; diagnosis and prognosis; prescribing drugs, medication or appliances; initiation of treatment without prior instruction by a veterinarian except as outlined under emergency animal care.

(a) Immediate supervision. A veterinary technician may perform the following tasks only under the immediate supervision of a veterinarian:

(i) Assist veterinarian in surgery by tissue handling;

(ii) Assist veterinarian in surgery by instrument handling;

(iii) Dental extractions.

(b) Direct supervision. A veterinary technician may perform the following tasks under the direct supervision of a veterinarian:

(i) Endotracheal intubation;

(ii) Blood administration;

(iii) Fluid aspiration, including cystocentesis;

(iv) Intraperitoneal injections;

(v) Monitoring of vital signs of anesthetized patient;

(vi) Application of splints;

(vii) Induce anesthesia by intravenous, intramuscular, or subcutaneous injection or by inhalation;

(viii) Administration of immunological agents including rabies vaccination;

(ix) Catheterization of the unobstructed bladder;

(x) Ophthalmological procedure including:

(A) Tear production testing

(B) Topical anesthetic application

(C) Fluorescein staining of the cornea

(D) Tonometry;

(xi) Teeth cleaning, provided an oral examination of the anesthetized patient has been conducted by the veterinarian;

(xii) Microchip implantation;

(xiii) Floating teeth;

(xiv) Removal of partially exposed foxtails and porcupine quills;

(xv) Provide massage;

(xvi) Suturing. The use of a needle, cutting or tapered, and suture material, staples, wound clips or tissue glue to close a skin or gingival incision or prepared wound as directed by the attending licensed veterinarian under direct supervision. Suturing may include the use of needle holders, thumb forceps, tissue forceps, retractors and comparable instruments for gentle handling of the tissues to be repaired/closed by such suturing. Suturing does not include the use of cutting instruments such as scalpels, scissors, electrosurgical equipment or other instruments to remove skin or other tissues from the animal patient.

(c) Indirect supervision. A veterinary technician may perform the following tasks under the indirect supervision of a veterinarian. If the animal is anesthetized, these tasks require the direct supervision of a veterinarian((.)):

(i) Enema;

(ii) Electrocardiography;

(iii) Application of bandages;

(iv) Gavage;

(v) Ear flush;

(vi) Radiology;

(A) Patient positioning;

(B) Operation of radiograph machines;

(C) Oral and rectal administration of radio-opaque materials;

(vii) Placement and securing of an intravenous catheter;

(viii) Injections of medications not otherwise prohibited:

(A) Intramuscular, excluding immunological agents

(B) Subcutaneous, excluding immunological agents

(C) Intravenous, including giving medication through an established intravenous catheter;

(ix) Oral medications;

(x) Topical medications;

(xi) Laboratory (specimen collections):

(A) Collection of tissue during or after a veterinarian has performed a necropsy

(B) Urine, except cystocentesis

(C) Blood

(D) Parasitology

(E) Exfoliative cytology

(F) Microbiology

(G) Fecal material

(xii) Laboratory (specimen testing):

(A) Urinalysis

(B) Hematology

(C) Serology

(D) Chemistries

(E) Endocrinology

(F) Parasitology

(G) Exfoliative cytology

(H) Microbiology

(I) Fecal analysis;

(xiii) Administration of preanesthetic drugs;

(xiv) Oxygen therapy;

(xv) Euthanasia in all circumstances as otherwise allowed by law;

(xvi) Removal of sutures;

(xvii) Indirect blood pressure measurement;

(xviii) Obtaining a general history from a client of a patient and the client's concerns regarding that patient;

(xix) Preliminary physical examination including temperature, pulse and respiration;

(xx) Behavioral consultation with clients;

(xxi) Dietary consultation with clients.

(2) Unregistered assistants.

Induction of anesthesia by any method is prohibited.

(a) Immediate supervision by veterinarian. An unregistered assistant may perform the following tasks only under the immediate supervision of a veterinarian:

(i) Assist veterinarian in surgery by tissue handling;

(ii) Assist veterinarian in surgery by instrument handling.

(b) Immediate supervision by veterinarian or veterinary technician. An unregistered assistant may perform the following tasks only under the immediate supervision of either a veterinarian or veterinary technician:

(i) Blood administration;

(ii) Laboratory (specimen collections):

(A) Hematology

(B) Exfoliative cytology, including skin scraping

(C) Microbiology

(D) Serology;

(iii) Placement and securing of an intravenous catheter.

(c) Direct supervision by veterinarian. An unregistered assistant may perform the following tasks only under the direct supervision of a veterinarian:

(i) Monitor vital signs of anesthetized patient;

(ii) Euthanasia in all circumstances as otherwise allowed by law;

(iii) Removal of sutures;

(iv) Teeth cleaning, provided an oral examination of the anesthetized patient has been conducted by the veterinarian;

(v) Provide massage;

(vi) Administration of immunological agents including rabies vaccination;

(vii) Microchip implantation;

(viii) Enema;

(ix) Removal of partially exposed foxtails and porcupine quills from skin and feet.

(d) Direct supervision by veterinarian or veterinary technician. An unregistered assistant may perform the following tasks under direct supervision of either a veterinarian or veterinary technician. If the animal is anesthetized, these tasks require immediate supervision of a veterinarian or a veterinary technician:

(i) Application of bandages;

(ii) Ear flush;

(iii) Electrocardiography;

(iv) Intramuscular or subcutaneous injections of medications not otherwise prohibited;

(v) Laboratory (test preparation, not evaluation):

(A) Parasitology

(B) Serology

(C) Urinalysis;

(vi) Preliminary physical examination including temperature, pulse and respiration;

(vii) Radiology:

(A) Patient positioning

(B) Operation of radiograph machines

(C) Rectal and oral administration of radio-opaque materials.

(e) Indirect supervision. An unregistered assistant may perform the following tasks under the indirect supervision of a veterinarian. If the animal is anesthetized, these tasks require the direct supervision of a veterinarian:

(i) Oral medications;

(ii) Topical medications;

(iii) Laboratory (specimen collection):

Collecting of voided urine and fecal material;

(iv) Oxygen therapy;

(v) Obtaining a general history from a client of a patient and the client's concerns;

(vi) Behavioral consultation with clients;

(vii) Dietary consultation with clients.

(3) Emergency animal care.

(a) Under conditions of an emergency, a veterinary technician and unregistered assistant may render certain life saving aid to an animal. A veterinary technician may:

(i) Apply tourniquets and/or pressure bandages to control hemorrhage;

(ii) Administer pharmacologic agents to prevent or control shock. Placement of an intravenous catheter and administering parenteral fluids, must only be performed after direct communication with a veterinarian, and only if the veterinarian is either present or immediately ((enroute)) en route to the location of the distressed animal;

(iii) Administer resuscitative oxygen procedures;

(iv) Establish open airways including the use of intubation appliances, but excluding surgery;

(v) Administer external cardiac resuscitation;

(vi) Apply temporary splints or bandages to prevent further injury to bones or soft tissues;

(vii) Apply appropriate wound dressings and external supportive treatment in severe burn cases;

(viii) Apply external supportive treatment to stabilize body temperature.

(b) An unregistered assistant may:

(i) Apply tourniquets and/or pressure bandages to control hemorrhage;

(ii) Administer resuscitative oxygen procedures;

(iii) Establish open airways including intubation appliances, but excluding surgery;

(iv) Apply external supportive treatment to stabilize body temperature.

[Statutory Authority: RCW 18.92.030. 02-02-046, 246-935-050, filed 12/27/01, effective 1/27/02; 91-02-060 (Order 108B), recodified as 246-935-050, filed 12/28/90, effective 1/31/91. Statutory Authority: RCW 18.92.015 and 18.92.030. 83-19-055 (Order PL 445), 308-156-050, filed 9/19/83.]

Washington State Code Reviser's Office