Question: I work out of a first response vehicle. If I start an IV to deliver a med such as gravol, and the patient will not require anymore treatment via IV and I am handing the patient over to a crew that is not IV certified what is my responsibility? Do I have to accompany the patient? Or can I lock the IV or can they monitor the IV TKVO?

 Thanks for the question. Please take a moment to review the SWORBHP policy regarding ACP and PCP paramedics in similar situations to what you describe.

This can be found on our website here: www.lhsc.on.ca/About_Us/Base_Hospital_Program/OpsLogistics/PPManualFinalAug2011_CrewConfiguration.pdf

Specifically, the ACP must attend when the patient has received, requires, or is anticipated to require an intervention or treatment beyond the PCP scope of practice. The ACP will not perform ACP medical directives and then transfer patient care to a PCP crew for transportation to the hospital unless there are extenuating circumstances. This must be documented on an incident report and submitted to the SWORBHP.

In some instances, the first response vehicle is staffed by a PCP. In this situation, the same answer applies. IV certified PCP (or ACP) should not transfer care to a non IV certified PCP crew for transport if they had required an intervention such as an IV initiation. If later on transport this patient required a fluid bolus for instance (perhaps the original indication for the IV start) then this second crew would not be able to provide this intervention.

Miscellaneous,Policy/Procedures

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