I am in a national guard unit. We currently don't have a doc or PA. I am the section Sgt and have never not had a PA and I was just told that I have a medic buy med and giving them to soldiers. Can he do this without a doc or PA and if not where is the reg so I can counsel him?

I don't know of the reg off the top of my head but if he is acting in the capacity of a medic and dispensing medications without permission is in violation of your states prescription authority laws. Especially if you are in a drilling status and not on federal orders.

Aside from what the law states he is voilating a public trust. If he is representing the medical department people are going to assume that he is competant and qualified to dispense. It would be the same as if you went to the hospital and somebody in a lab coat started talking to you about surgery options. If you found out it was an RN you would probably feel decieved.

Additionally I would recommend finding out if your state has written protocols for medics. Rememeber, even a bag of normal saline says, "For use or sale only on the order of a physician." If you don't have standing orders you're really only going to be splinting, and applying ice. Otherwise you may end up in legal hot water.

MIKE

Well said. That also applies to over-the-counter (non-prescription) medications, too.

You're limited to what you were trained and are competent/certified to do: splint, bandage, elevate, apply heat or cold, comfort measures until more skilled medical assistance is available, the patient recovers or is evacuated - whatever comes first.

In a word...

NO

Suggestion...
Contact your next higher authority and request written protocols from that level SGN. BDE / DIV etc...
Until then...stay within the realm of your medical competencies as outlined in your skill level POI.
"State Rules" have nothing to do with military personnel dispensing medications. Your liability level increases dramatically once you being acting outside your credentials.

PA

quote:

Originally posted by Cider33_Alpha:
Well said. That also applies to over-the-counter (non-prescription) medications, too.

You're limited to what you were trained and are competent/certified to do: splint, bandage, elevate, apply heat or cold, comfort measures until more skilled medical assistance is available, the patient recovers or is evacuated - whatever comes first.

My unit has never said that. We were told OTC meds were okay to dispense as long as we followed the recommended dosaging. That is very interesting and I will ask my PA about it. BTW we are a medical support unit. And we were trained in pain killers and antibiotics in AIT. Now on the civilian side we arent supposed to give even OTC meds to a PT. And there is a laundry list of protocols to even assist with meds prescribed to the PT.

saturdaysoldier -

Your situation is far different from the OP's. In the first place, you have a PA and operate under his/her supervision (figuratively if not literally), and he/she operates under the umbrella of physician oversight. The OP is out swinging in the wind ...

Most of us in the health fields are taught basics of things that are legally beyond our scopes of practice, whether civilian or military. Know your scope of practice, local protocols and what they allow you to do, and have the skills necessary to do what you are authorized to do. That keeps everybody out of trouble.

quote:

Originally posted by Cider33_Alpha:
saturdaysoldier -

Your situation is far different from the OP's. In the first place, you have a PA and operate under his/her supervision (figuratively if not literally), and he/she operates under the umbrella of physician oversight. The OP is out swinging in the wind ...

Most of us in the health fields are taught basics of things that are legally beyond our scopes of practice, whether civilian or military. Know your scope of practice, local protocols and what they allow you to do, and have the skills necessary to do what you are authorized to do. That keeps everybody out of trouble.

I always though you had to operate under a PA or DOC regardless of the type of unit. Maybe even though there is not a PA with the OP's unit they still operate under a PA with another unit.

That would depend on the org chart/chain of command. Personally, I would NOT like to be leaning on the credentials of some other dude who doesn't know me from Adam when I'm out there in the field or on some weekend drill.

CYA, ya know?

Your unit should have an SOP regarding this issue. If your unit does not have an MD or PA, then there should be some medical oversight from the next higher level of your command (brigade or medical support company).

As previously stated, an IV is a prescription medication. So is oxygen.

It's reasonable for medics to dispense OTC meds, since they did receive training on this in AIT, provided they are given within the dosage guidelines.

Certaninly prescription medications are not appropriate to be dispensed without further medical oversight/authority.

If IVs are persciption, then what covers CLS's giving IVs at drills?

btw, I'm in a similar situation with no PA/MD above me, but I have no ability to order medical supplies anyway so this issue hasn't come up.

Ordering medical supplies and ordering their USE are two entirely separater things.

Regarding drills with administrations of IVs as part of training: training is supposed to be monitored by someone with sufficient authority to prescribe (if necessary, as it would be in this case) infusion of IV fluids.

This is above your pay grade. Get it? Make sure you chain of command gets it too.

quote:

Originally posted by Sgt_Nemec:
If IVs are persciption, then what covers CLS's giving IVs at drills?

Good question, it may be the answer is 'nothing.' If there are not written protocols in place signed by a competant medical authority (MD, NP, PA) then they cannot give IVs. It really doesn't matter what you were trained to do. Only what you currently have permission to do. If the battalion PA has not signed off on treatment algorythms or protocols stating that the CLSs may insert IVs then they do not currently have permission to do so.

MIKE

I was workng nights at Balboa Medical Center and I heard this from the day shift charge nurse that relieved my team. A newly hired civilian RN was doing her floor orientation on my end of the week for day shift. A resident (medical corps officer) had asker her a few times to put another IV in one of his patients. She told him that since she hadn't been through the Nursing Orientation class conducted twice a month by the Staff Education & Training department that she could not handle any of the equipment (that is no adjusting IV flow rates, no finger stick blood sugar, nothing).

He told her it was ok, if anyone complained he would cover for her. Well, she put the IV in the patient. Since she was about 2 days into her one year probation period they canned her that day.

She wasn't signed off at that medical center to put IVs in, and she knew that to be the fact, yet she did it anyways.

The doctor continued on with his residency.

The moral of the story is this: Unless it is in writing you shouldn't be doing it. I've seen at least 3 Soldiers come into the ER with a fever that turned into sepsis because of the crud that went into them with the IV cath. I can all but guarantee you if they did not have permission to start IVs they would be hung out to dry. All it takes is a few e-mails to get written protocols and get those documents passed out to all the people concerned.

MIKE