MetalMedic Posted December 2, 2012 Share Posted December 2, 2012 Hey everyone! Long time no post! I've been busy, unfortunatley, I lost my paid job in May, but it "forced" me into Paramedic school. I'm still currently on the volley side and am still looking for paid gigs. Anyway... Our instructor asked us to research a few things for class on Monday and I am struggling to find where to look. The topic we covered on Monday was in regards to Med Control and all things surrounding it. We have been asked to find out if a MD or DO can delegate orders to another and if that person can carry them out. For example, as Paramedics we are allowed to use up to 10mg of drug X. The nurses are allowed to give up to 12mg of drug X. If the nurse responds to the patch, can they authorize us the extra 2mg? Most of the class said no, but on top of being a Paramedic, our instructor is also a full time lawyer, so he wants proof to back it up, not just "Well that's what we were told." I'm not having any luck from searching google for patches as all I come up with are patches for clothing. I've already checked our regional protocols and all I find is information on procedures for patient care and drug reference guides. Does anyone else have any suggestions on where to look? I currently live in Connecticut, so I know that other states may have different protocols on who can respond to med patches. Much appreciated! -MetalMedic Link to comment Share on other sites More sharing options...
Arctickat Posted December 2, 2012 Share Posted December 2, 2012 (edited) Have you asked these guys? BTW, the answer is no because a nurse is not a doctor. You work as an extension of a medical license, not a nursing license. Edited December 2, 2012 by Arctickat Link to comment Share on other sites More sharing options...
MetalMedic Posted December 2, 2012 Author Share Posted December 2, 2012 Yeah I've checked on that site, but nothing specific about a MD/DO not being able to delagate to RN for med patches. Even though it's a med license we work under, some RN's are allowed to precribe meds and we are all allied health. So I'm just trying to find something in writing that has a clear line. The public health website states that a MD/DO can delagate to properly trained and certified individuals. So that doesn't really help narrow it down, but thanks! Link to comment Share on other sites More sharing options...
Arctickat Posted December 2, 2012 Share Posted December 2, 2012 (edited) When I suggested that website I was thinking more about looking up their contact info and speaking to one of your regulators. Sorry I can't point you straight to the answer, but I wouldn't know where to find it. it is an interesting Medicolegal question though. For example, up here we are currently absolutely not permitted to exceed our scope even if medical control requests us to do it. So, if we have a maximum permitted medication dose, that's it...no more can be given by the medics. However, there is a push on to have us removed from the cookbook medic philosophy and permit us to use some of our own critical thinking abilities when it comes to patient care. I'm hopeful that this will result in paramedics being less fearful of repercussion should they stick a toe over the protocol line such as your example provides. The main difference is that we have our own license, we don't function as an extension. We still have to consult with medical control at times though for some procedures. Edited December 2, 2012 by Arctickat Link to comment Share on other sites More sharing options...
MetalMedic Posted December 4, 2012 Author Share Posted December 4, 2012 (edited) Thanks for the advice. I checked the RN scope of practice, the DEA and found some basic information on the site we both located. I also left a message for the state medical board. Turns out what I'm looking for doesn't really exist in the form I was looking for. But I was able to point out based on DEA regulations and Scope of Practice for RN's that they are not able to authorize meds for those reasons. In CT: Esentially Nurses are allowed to administer medications, and by providing information to "go ahead" over a med patch it would be a perscription as their orders and protocols are not the same as ours. State protocols do allow doctors to deligate authority with in scope of practice. Also, in CT nurses do not have any authority in the pre-hospital setting. Whew. Lot of research to get to that point, but it was a good question and a great class discussion. And thankfully, even though I didn't have direction information I was able to have enough resources to back up the information to my lawyer instructor. Thanks for the help! Aside note: Even though Paramedics have our own licenses (well not me yet) we are an extension of the MD, DO license. = Medical Control Edited December 4, 2012 by MetalMedic 1 Link to comment Share on other sites More sharing options...
island emt Posted December 4, 2012 Share Posted December 4, 2012 In many areas the duties of being the medcom phone answering point is delegated to RN's and even some areas , Paramedics. That said , If your requesting to go outside your published protocols , then you need to speak to an MD/ DO who is granting an exception to the published protocols. Document in your report , time and who you spoke to to go outside the protocol. This doesn't mean you can preform invasive skills outside your scope of practice, such as an EMT basic doing a chest decompression or surgical cric, without putting your license on the line. charges will be filed and you will have to face the consequences of your actions , even if a doc told you to do so. Link to comment Share on other sites More sharing options...
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