Date Published

January 29, 2021

Updated For

ALS PCS Version ALS PCS Version 5.2


Question re potential med administration through a PICC line; would it be prudent to patch to Base Hospital for direction/permission to administer Gravol for example, in a pt who is declining additional IV initiation but already has a PICC line established and knowledge of how they self-administer their own medications? Thank you.


A PICC line (Peripherally Inserted Central Catheter) is a form of Central Venous Access Device (CVAD). Therefore, only ACP and CCP certified medics authorized to use the Central Venous Access Device Medical Directive can utilize this access. This act cannot be delegated to PCPs as it is a Schedule 3 Controlled Act under the Ambulance Act Regulation 257/00. As such, we would not be able to allow use even in special situations, as we would not have the provincial legal authority.

Controlled Acts Under Regulation 257/00 - Emergency Health Services Programs and Services  Health Care Professionals MOHLTC (

For a patient who declines further access, and do not meet CVAD Medical Directive Indications, we suggest explaining that there is risk associated with accessing CVAD devices. The risks include introducing infection and the fact training is required in order to access this type of device.

Furthermore, Gravol would not be indicated via the CVAD route, even for those certified to utilize this route.



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