Question regarding definition of standing orders?

[photo-susie-emt]

Ok so this may be a stupid question but i will ask. I was reading about legale parts of the EMS systems and about Standing orders and Off-line medical direction. My question is what is the difference exatly they sound almost the same?

Standing orders- a written order issued by a medical director that alows the EMT's and others to perform particular skills in certain situations without medical direction contact.

Off-line medical direction- consists of standing orders issued by the medical director that allwos the EMT's to give certain medications or perform certain procedures without speaking to the medical director or another physician.

[AnthonyM83]

The way I understand it, offline and online medical control are classifications.

From there, a standing order could be written for prehospital care providers to read, memorize, and follow (offline medical control).

BUT, a standing order could also be written for the physicians manning the radio room to guide them in advising prehospital personnel over the phone.

So, in effect it standing orders and offline medical direction ends up being the same thing for us...but in technicality there is a difference.

OR it could just be two systems using two different terms for the same thing....or want you to view things from the angle of online versus offline for whatever reason.

[photo-susie-emt]

Ok that sounds a little confusing sorry

[akflightmedic]

You have two types of medical cotrol.

1. Off line

2. Online

Off line medical control is also known as/considered to be "Standing Orders".

Standing orders are exactly that...they are a doctors orders for you to do this or that depending on whatever the occasion may be without contacting the medical director or the physician on duty for guidance.

Online medical control is when you have a doctor on phone, radio, webcam, whatever your system uses because of:

1. Your standing orders do not apply to this situation

2. You need to do something not covered within the standing orders and you want permission or guidance

3. You are just down right unsure of how to proceed

Does this clarify it for you?

[photo-susie-emt]

Yes that clarifyed it alot better!!! Thanks so much your all helpful!!!

[HellsBells]

Actually my understanding of these concepts are that:

Standing Orders are guidelines that the prehospital care provider is to follow in pre-approved situations. This can apply to online or offline medical control. In a system where you are under online medical control and for some reason unable to get into contact with medical control (due to communication system failure, etc.) you can follow the "standing orders" in regards to pt care.

Offline control allows you to follow standing orders without even attempting to call med control.

[akflightmedic]

Standing orders are no longer "standing" if you have to reach ONLINE control to do or perform them unless in your guideline book it states to contact med control prior to doing XYZ intervention. In addition, contacting medical control is to gain permission or information on how to do something outside the norm of your standing orders.

Standing orders "stand alone" meaning you perform them with no oversight. It is set treatment in set situation.

An online doc can elect to take you above a higher level or deviate from, meaning beyond the normal pre-set standing orders, but again this is done with online guidance and as long as it complies with your scope of practice within your state for whatever level you are at.

[Arizonaffcep]

Actually my understanding of these concepts are that:

Standing Orders are [s:d2c4fd4219]guidelines[/s:d2c4fd4219] orders that the prehospital care provider is to follow in pre-approved situations. This can apply to online or offline medical control. In a system where you are under online medical control and for some reason unable to get into contact with medical control (due to communication system failure, etc.) you can follow the "standing orders" in regards to pt care.

Offline control allows you to follow standing orders without even attempting to call med control.

Standing orders cannot be deviated from, without SUBSTANTIAL reason (ie allergy to certain med). In reference to the last sentence, at least in Southern AZ, you still have to notify Meds Control (who relays to the receiving hospital) what standing order you are following, age of Pt, stable/unstable, transporting code 2/3, etc.). The good thing is, that's the extent of the communication.

[AnthonyM83]

Standing orders are no longer "standing" if you have to reach ONLINE control to do or perform them unless in your guideline book it states to contact med control prior to doing XYZ intervention.

That's kind of what I was trying to say.

For EMT class, Standing Orders and Offline Medical Control can pretty much be the same thing.

But if for purposes of discussion, we're trying to be technical, then a standing order may be pre-written, but require online medical control to approve its use. In LA, online medical control has very strict rules on how to advise over the phone...the nurse on the phone is following a standing order telling her that if such and such circumstances are present, she can allow use such and such med.

[akflightmedic]

That's kind of what I was trying to say.

For EMT class, Standing Orders and Offline Medical Control can pretty much be the same thing.

But if for purposes of discussion, we're trying to be technical, then a standing order may be pre-written, but require online medical control to approve its use. In LA, online medical control has very strict rules on how to advise over the phone...the nurse on the phone is following a standing order telling her that if such and such circumstances are present, she can allow use such and such med.

I was trying to give her, the newbie NON EMT a most correct answer in about 99% of the country.