Alaska guides RN moderate sedation through a Board of Nursing advisory opinion — two headline findings, then the conditions for moderate procedural sedation in the acute care setting, with shorter sections for the intubated/ventilated patient, emergency rapid sequence intubation and emergency patient transportation (pp. 6–8). Everything below is quoted or paraphrased from the Board’s 13-page PDF, with page numbers.
Alaska at a glance
| Board | Alaska Board of Nursing (p. 1) |
| Document | Advisory opinion, “Registered Nurse Administration of Sedating and Anesthetic Agents” (p. 1) — 13-page PDF (nur1809.pdf); page numbers on this page refer to it. |
| Rule it applies | One statute, and it is the publishing authority, not the operative rule: advisory opinions are published “in accordance with AS 08.68.100(a)(9)” (p. 1). No Alaska Administrative Code section is cited. |
| Status | Advisory opinion — “an interpretation of what the law requires. While an advisory opinion is not law, it is more than a recommendation” (p. 1). |
| Dates | Approved June 2006 and August 2023; revised 10 May 2023; reviewed 2006–2009 (all p. 1). No effective date, review cycle or expiry is stated. |
| Who it covers | The Registered Nurse, “other than a Certified Registered Nurse Anesthetist (CRNA)” (p. 2). The cover form marks APRN and RN, with LPN and CNA unmarked (p. 1) — but see the next row. |
| Who it does not cover | LPNs and unlicensed staff — moderate procedural sedation “exceeds the scope of practice for the Licensed Practical Nurse (LPN) or unlicensed assistive personnel (UAP)” (p. 2). The guidelines “do not apply to” CRNAs or appropriately credentialed Advanced Nurse Practitioners (p. 2). |
| Settings the document names | One: the acute care setting — the other circumstances it allows are “exclusively in the acute care setting” (p. 2), and the Appendix defines the term as “An emergency department, intensive care unit, or other specialized care area in which Licensed Independent Practitioners are immediately available” (p. 10). The words office, ambulatory and outpatient do not appear in the document. |
| Re-verification interval | Not stated. The opinion asks for “ongoing competency” (p. 3) and requires that “Facilities doing this training must maintain competency documentation” (p. 8), without naming a period. |
| Where the record lives | Either side of the Board’s “and/or”: competency “is evidenced in personnel files and/or individual portfolios” (p. 3, repeated p. 6) — the employer’s file, the nurse’s own portfolio, or both. |
| CE hours | Not stated — no contact-hour count, no renewal-CE condition. The Scope Statement states it in general terms: RN sedation “requires additional education and specific competency” (p. 2), no hours attached. The only named courses are the resuscitation ones: “through Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS) or equivalent training” (p. 4) — “or equivalent training” is the Board’s wording, so the list is not closed at those two. Section IV adds “specialized training in emergency patient transportation” (p. 8). |
What the Alaska Board of Nursing says
Two numbered findings open the opinion: RNs may not perform deep sedation, and the medication for minimal or moderate sedation “is left to the clinical judgment of the licensed independent provider” (p. 1). Deep sedation has not vanished from the text, though: the opinion’s requirements “must be followed” if a patient “progresses to the level of deep sedation or general anesthesia” (p. 3).
The permission is conditional: the Board finds it within the RN’s role and scope to give sedating and anesthetic agents for moderate procedural sedation to the non-intubated or intubated/ventilated patient, “under the direction of a LIP, in the acute care setting, in accordance with the guidelines in this advisory opinion” (p. 2). Sedating agents for “minimal sedation (anxiolysis)” are separately within scope, though “Anesthetic agents (such as propofol, etomidate, etc.) would not be appropriate” for that (p. 2).
The ASA gate is numeric. An RN may give moderate procedural sedation to an adult “with an ASA score of I or II, if all the criteria detailed in this policy guidelines are met” (p. 3, typo as printed), and “may NOT administer to adult patients with an ASA score of III or IV unless a CRNA, or LIP credentialed by the facility in moderate procedural sedation, and competent in intubation and airway management is immediately available” (p. 3). The pediatric paragraph repeats the structure for patients under 18 (p. 3).
Section I sets the conditions (pp. 3–6). Personnel must be able “to rescue the patient at one level deeper than the planned sedation” (p. 5) — the section I standard; for the intubated/ventilated patient, section II asks instead for “the capability to rescue the patient should the airway or hemodynamic status be compromised” (p. 7). The monitoring nurse “may not leave the patient unattended or perform other tasks that would compromise patient monitoring, including performance of the procedure itself” (p. 6) — do not quote that sentence without its qualifier. The knowledge-and-skills list is prefaced:
“Education, training, experience and ongoing competency appropriate to responsibilities, treatment provided, and the patient/population served is evidenced in personnel files and/or individual portfolios.”
Alaska Board of Nursing — Advisory Opinion, Registered Nurse Administration of Sedating and Anesthetic Agents (p. 3)
What an Alaska facility should be able to show
“It is not the Board’s role to develop policy for the acute care practice setting” (p. 5), and the opinion makes the individual RN responsible for confirming the setting conditions are met. Three records follow:
- The written sedation policies and protocols — “readily available and are medically approved” (p. 5) — with the “Written risk management and quality improvement plan in place” (p. 5) beside them.
- Per-nurse evidence of the initial knowledge and skills in the section I.A list for moderate procedural sedation — anatomy and physiology, pharmacology, physiologic measurement, intervention in complications, total-patient assessment including recovery, and ASA classification (pp. 3–4) — held in personnel files or individual portfolios. Its resuscitation item points outside any sedation course: “through Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS) or equivalent training” (p. 4), naming the training, not a card.
- Per-nurse evidence of ongoing competency, on an interval your own policy names since the opinion names none, together with the facility-side record it does require: “Facilities doing this training must maintain competency documentation” (p. 8).
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Questions Alaska facilities ask
Is an Alaska advisory opinion binding on an RN?
The Board’s own answer is that it is “more than a recommendation” but “not law” (p. 1). Treat it as the Board’s stated interpretation, not a statute. It writes most of its own conditions in “must” form (22 times; shall, not at all), and says facility policies “may restrict practice further in their setting and/or require additional expectations related to competency, validation, training, and supervision” (p. 1) — permission for the facility rather than an expectation the Board states.
Does the opinion set a re-verification interval, or require a particular sedation course?
No — it sets none and requires none. It asks for “ongoing competency” (p. 3) without stating how often competency is re-established, and the only courses it names are the resuscitation ones, which it opens to alternatives: “or equivalent training” (p. 4). No state mandates this specific course. The interval and the evidence are yours to define.
Does this opinion apply outside an acute care setting?
Its scope findings are all stated for the acute care setting (p. 2), and it names no practice setting other than that one, so it does not supply a standard for another. That is a limit on settings, not on situations: inside the acute care frame it also reaches emergency rapid sequence intubation and emergency patient transportation, which carry requirements of their own (p. 8). A non-acute unit is measured against its own policy and its licensing regulator’s requirements; the Board’s silence is not an absence of requirements, only the Board not being the source of them there.
Compliance note (last reviewed September 2026): This page is educational information about the Alaska Board of Nursing advisory opinion Registered Nurse Administration of Sedating and Anesthetic Agents, not legal advice or a compliance determination. Every quotation was checked word-for-word against the Board’s 13-page PDF on 2026-09-02; page numbers refer to that PDF. On the same day the PDF was re-downloaded from the Board’s own URL and matched the banked copy byte for byte (SHA-256 45e8f4a5…), though the Board’s HTML advisory-opinion index refused automated requests, so the index listing itself was not re-read. Board typographical errors are reproduced as printed. Confirm the current revision and your own facility policy before relying on this summary. No state mandates this specific course.