Delaware Code
Subchapter XII. Professional Polysomnographers
§ 1799U. Definitions.

As used in this subchapter:

(1) “AASM” shall mean the American Academy of Sleep Medicine or an organization that is recognized as equivalent.
(2) “Board” shall mean the Board of Medical Licensure and Discipline.
(3) “BRPT” shall mean the Board of Registered Polysomnographic Technologists or its successor organization.
(4) “Council” means the Polysomnography Advisory Council.
(5) “Direct supervision” means that the licensed polysomnographer providing supervision must be present in the area where the polysomnographic procedure is being performed and immediately available to furnish assistance and direction throughout the performance of the procedure.
(6) “General supervision” means that the licensed polysomnographer works under the supervision of a person licensed to practice medicine, whether by direct observation and monitoring, by protocols approved by a person licensed to practice medicine, or by orders written or verbally given by a person licensed to practice medicine. A licensed polysomnographer may evaluate patients and make decisions within parameters defined by a person certified to practice medicine and by the Board. The licensed polysomnographer works under a physician's overall direction and control, but the physician's presence is not required during the performance of the procedure.
(7) “License” shall mean any document which indicates that a person is currently licensed by the Board to practice polysomnography.
(8) “LPSGT” shall be the abbreviation for the title “licensed polysomnographer”.
(9) “NBRC SDS exam” means the National Board for Respiratory Care Sleep Disorders and Therapeutic Intervention Respiratory Care Specialist exam.
(10) “Polysomnographer” means an allied health professional, practicing polysomnography under the direction of a person licensed to practice medicine, who is responsible for direct and indirect services in the treatment, management, diagnostic testing, control, and care of patients with deficiencies and abnormalities associated with the human sleep wake cycle.
(11) “Polysomnographic student” means a person who is enrolled in an accredited educational program described in § 1799V of this title and who may provide sleep-related services under the direct supervision of a licensed polysomnographer as a part of the person's educational program and is therefore, exempt from the licensure requirement.
(12) “Polysomnographic trainee” means a person who has completed an accredited educational program described in § 1799V of this title and who may provide sleep-related services under the direct supervision of a licensed polysomnographer as part of the person's clinical program and is therefore exempt from the licensure requirement.
(13) “Practice of polysomnography” means the performance of any of the following tasks as directly related to the diagnosis and treatment of sleep-related disorders, under the general supervision of a licensed physician:

a. Monitoring and recording physiologic data during the evaluation of sleep-related disorders, including sleep-related respiratory disturbances, by applying the following techniques, equipment, and procedures:

1. Titration using approved airway pressure devices and/or other technologies on spontaneously breathing patients using a mask or oral appliance, provided the mask or oral appliance does not extend into the trachea or attach to an artificial airway;
2. Supplemental low flow oxygen therapy (less than or equal to 6 liters per minute) during a polysomnogram utilizing a nasal cannula or approved airway pressure devices and technologies on spontaneously breathing patients, provided the devices or technologies do not extend into the trachea or attach to an artificial airway;
3. Capnography during a polysomnogram;
4. Cardiopulmonary resuscitation;
5. Pulse oximetry;
6. Gastroesophageal pH monitoring;
7. Esophageal pressure monitoring;
8. Sleep staging (including surface electroencephalography, surface electrooculography, and surface submental electromyography);
9. Surface electromyography;
10. Electrocardiography;
11. Respiratory effort monitoring, including thoracic and abdominal movement;
12. Plethysmography blood flow monitoring;
13. Snore monitoring;
14. Audio and video monitoring;
15. Body movement and body position monitoring;
16. Nocturnal penile tumescence monitoring;
17. Nasal and oral airflow monitoring;
18. Body temperature monitoring;
19. Monitoring the effects that a mask or oral appliance used to treat sleep disorders has on sleep patterns; provided, however, the mask or oral appliance shall not extend into the trachea or attach to an artificial airway;
20. Actigraphy;
b. Observing and monitoring physical signs and symptoms, general behavior, and general physical response to polysomnographic evaluation and recommending whether initiation, modification, or discontinuation of a treatment regimen is warranted;
c. Analyzing and scoring data collected during the monitoring described in paragraphs (13)a.1. and 2. of this section for the purpose of assisting a licensed physician in the diagnosis and treatment of sleep and wake disorders;
d. Implementation of a written or verbal order from a licensed physician which requires the practice of polysomnography;
e. Education of a patient regarding sleep disorders and the treatment regimen which assists that patient in improving the patient's sleep.