Under section 18VAC6O-21-260 K.2e and under Under section 18VAC6O-21-291 D.2e we need clarification as to how often the vital signs has to be recorded. You cant record blood pressure every second, the machine takes longer than that to take it. Why did you get rid of the every 5 minutes. It is impossible to do it every second. You need a time measure, every 5 min for instance. If you dont have a specified time measure you open yourself up to people doing it every 10 min, 15 min etc. 

Under section 18VAC6O-21-260 C required staffing. I agree with the other commenters. For this level of sedation 2 people is sufficient. Requiring 3 people is against other national guidelines and would mean the dental board of Virginia is establishing their own national guidelines.  The ada guidelines also only support a 2nd person not a 3rd.