CRNA
Scope of Practice
- All Certified Registered Nurse Anesthetists (CRNA) must hold an active South Dakota nursing license to practice nursing.
- SDCL 36-9-3.1 outlines the legal scope of practice for CRNAs who practice in the state of South Dakota, in-person or via telehealth.
- Nurses and employers are encouraged to use the Board's APRN Scope of Practice Decisioning Algorithm as a guide to making decisions on whether a specific task, intervention, or activity is in a CRNA's scope.
Telehealth
- All health care providers, including nurses, are expected to adhere to the requirements in SDCL 34-52 when providing services to patients located in South Dakota through telehealth. SDCL 34-52 includes the definition of telehealth and the requirements for treatment of patients, provider-patient relationship and exceptions, consultation recommendations, examination, prescribing, informed consent, and medical records.
Collaboration Requirement
- CRNAs are required to collaborate with a physician, dentist, podiatrist, certified nurse practitioner, certified nurse midwife, or a physician assistant when providing anesthesia services; or other health care providers when engaging in chronic pain practice.
- Collaboration is defined in SDCL 36-9-1 (7), as "the act of communicating pertinent information or consulting with a licensed physician or other licensed health care provider with each provider contributing the provider's respective expertise to optimize the overall care delivered to the patient.”
Prescribing 
- Upon licensure a CRNA may prescribe, procure, furnish, and administer over-the-counter, legend, and controlled substance (CS) drugs (schedules II-IV as listed in SDCL 34-20B) within the CRNA's role and focus area.
- CRNAs who order CS drugs must meet requirements and be registered with the:
Nothing in SDCL 36-9-3.1 prohibits the practice of a CRNA to administer CS drugs, or to order CS preoperatively, intraoperatively or postoperatively in accordance with chapter 34-20B or per institutional policy.
Additional Links
- ARSD 20:48:04:08 -- Defines prescribing, provision of drug samples, board authority to sanction CRNA for inappropriate prescribing.
- ARSD 20:48:04:09 -- Provides guidelines for prescribing CS for treatment of chronic, non-cancer pain, lists documentation requirements, and state and federal registration requirements.
- CDC 2022 Clinical Practice Guideline for Prescribing Opioids for Pain
Pain Management & Radiography
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Prior to a CRNA performing pain management procedures or using fluoroscopy, the CRNA, who is not practicing in a licensed facility or institution, must complete a board-approved educational program specific to pain management and fluoroscopy and send the completion certificate to the board.
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Education content must include:
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Radiation physics, radiobiology, radiological safety, and radiation management, applicable to the use of fluoroscopy.
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Physiology of pain, pain assessment, and treatment options, and demonstration of competence to perform a procedure(s).
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Pain management procedures may include use of medications, regional anesthetic techniques, therapeutic injections, sympathetic blocks, and other pain relief modalities performed or administered in compliance with accepted standards of practice.
A CRNA who performs pain management procedures or uses fluoroscopy in an institution or health care setting, such as a hospital or surgical center, licensed under SDCL chapter 34-12, and who has met radiological requirements in ARSD 44:75 and 44:76, must meet the institution's requirements prior to using fluoroscopy or performing pain management procedures.
Pre-approved Education Courses:
- Chronic Pain Management and Fluoroscopy Courses:
- Email Lindsay Olson to request approval of a different course.
Applicable Rules
- ARSD 20:48:04:10 - Clarifies that CRNAs may order, interpret and supervise radiographic procedures, including fluoroscopy, according to ARSD chapter 44:03.
- ARSD 20:48:04:11 -- Specifies pain procedures CRNAs may perform with required education.