2025 -- H 5428

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LC000950

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     STATE OF RHODE ISLAND

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: Representatives McNamara, Corvese, Chippendale, Place, Craven,
Bennett, and Ackerman

     Date Introduced: February 12, 2025

     Referred To: House 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

adding thereto the following section:

     5-34-3.1. Safe administration of sedation.

     (a) Registered nurses (RNs) and advanced practice registered nurses (APRNs), other than

licensed certified registered nurse anesthetists (CRNAs), as defined in this chapter, and RNs

enrolled in a nurse anesthesiology training program approved by the Council on Accreditation of

Nurse Anesthesia Educational programs (COA) or its predecessors or successors, shall not

administer agents that are primarily used and classified as general anesthetics for minimal,

moderate, deep sedation, or general anesthesia including, propofol, Etomidate, sodium thiopental,

methohexital, or volatile gases (e.g. sevoflurane, isoflurane, desflurane), nor shall any RN or Non-

CRNA APRN administer or manage deep sedation or general anesthesia for any diagnostic,

therapeutic, or surgical procedures using any drug or medication.

     (b) For critical life-saving situations requiring the immediate and emergent facilitation of

airway management (rapid sequence intubation) or to maintain sedation for tracheally intubated

and mechanically ventilated patients, an RN acting as the third hand of a licensed APRN or

physician, or an APRN may initiate, titrate, and bolus intravenous/intraosseous (IV/IO) agents. An

APRN, may initiate, titrate, and bolus intravenous/intraosseous (IV/IO) agents if the APRN is

trained in airway management and acting within their scope of practice and approved by their

governing body, as authorized in this section.

     (c) For emergency situations where there is an imminent threat to life or limb, the APRN

or RN can administer anesthetic medications to preserve patient life including, but not limited to,

cardiac arrest, respiratory failure, and increased intracranial pressure, acting within their scope of

practice and approved by their governing body.

     (d) Nothing in this section shall prohibit the administration and/or titration of anesthetics

for patients being sedated in a critical care setting (emergency room, intensive care unit) and are

tracheally intubated, and mechanically ventilated by a RN or APRN acting within the scope of

practice and approved by their governing body.

     SECTION 2. Chapter 5-34.2 of the General Laws entitled "Nurse Anesthetists" is hereby

amended by adding thereto the following section:

     5-34.2-2.1. Safe administration of sedation.

     (a) Registered nurses (RNs) and advanced practice registered nurses (APRNs), other than

licensed certified registered nurse anesthetists (CRNAs), as defined in this chapter, and RNs

enrolled in a nurse anesthesiology training program approved by the Council on Accreditation of

Nurse Anesthesia Educational programs (COA) or its predecessors or successors, shall not

administer agents that are primarily used and classified as general anesthetics for minimal,

moderate, deep sedation, or general anesthesia including, propofol, Etomidate, sodium thiopental,

methohexital, or volatile gases (e.g. sevoflurane, isoflurane, desflurane), nor shall any RN or Non-

CRNA APRN administer or manage deep sedation or general anesthesia for any diagnostic,

therapeutic, or surgical procedures using any drug or medication.

     (b) For critical life-saving situations requiring the immediate and emergent facilitation of

airway management (rapid sequence intubation) or to maintain sedation for tracheally intubated

and mechanically ventilated patients, an RN acting as the third hand of a licensed APRN or

physician, or an APRN may initiate, titrate, and bolus intravenous/intraosseous (IV/IO) agents. An

APRN, may initiate, titrate, and bolus intravenous/intraosseous (IV/IO) agents if the APRN is

trained in airway management and acting within their scope of practice and approved by their

governing body, as authorized in this section.

     (c) For emergency situations where there is an imminent threat to life or limb, the APRN

or RN can administer anesthetic medications to preserve patient life including, but not limited to,

cardiac arrest, respiratory failure, and increased intracranial pressure, acting within their scope of

practice and approved by their governing body.

     (d) Nothing in this section shall prohibit the administration and/or titration of anesthetics

for patients being sedated in a critical care setting (emergency room, intensive care unit) and are

tracheally intubated, and mechanically ventilated by a RN or APRN acting within the scope of

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practice and approved by their governing body.

     SECTION 3. This act shall take effect upon passage.

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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,

Etomidate, sodium thiopental, methohexital, and volatile anesthetics for any surgery or procedure

is not, generally, within the “scope of practice” of registered nurses and non-CRNA advance

practice registered nurses as defined in chapter 34.3 of title 5 and would restrict the administration

of these medications to licensed certified registered nurse anesthetists. It would also detail each of

those limited emergency circumstances where a registered nurse and advanced practice registered

nurses, may safely administer sedation, such as critical life-saving or emergency situations where

there is an imminent threat to life or limb. This act would detail each of those limited emergency

circumstances where registered nurses and advanced practice registered nurses, may safely

administer sedation, such as critical life-saving or emergency situations where there is an imminent

threat to life or limb.

     This act would take effect upon passage.

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