My question is in regards to when an IV certified medic is working with a non-certified medic. If the certified medic establishes IV access and has a lock in place, but doesnt give any fluids or medications can the non-certified medic still continue to attend the call? Or does the certified one become the attending. Specific example would be a Code Stroke where we established IV access prior to leaving scene, but it was originally the non-certified medics call.
As soon as an IV is initiated, the IV Certified paramedic assumes patient care.
Even when IV cannulation is performed for potential need by receiving facility (ex. STEMI/Stroke Bypass) the IV certified paramedic must assume patient care. Per the OBHG Companion Document, "If the patient meets the criteria of the Paramedic Prompt Card for Acute Stroke Protocol or the STEMI Hospital Bypass Protocol Prompt Card then paramedics may consider the initiation of an intravenous. The initiation of an intravenous for these purposes should never delay transport and should only be attempted en route." Therefore, even if there is no anticipated need for prehospital IV utilization, the IV-certified paramedic should attend.
This aligns with the SWORBHP Policy PCP vs PCP Expanded Scope Crew Configuration €“ Division of Responsibilities states that any patient who has received treatment outside the scope of a PCP Paramedic, must be attended by a PCP Expanded Scope paramedic. IV initiation is considered a treatment which is outside the scope of the PCP Paramedic. In extenuating circumstances where the PCP Paramedic MUST assume care of the patient, a self-report must be submitted to SWORBHP.
This does not apply to patients who have an IV in situ upon paramedic arrival (to scene or for patient transfer).
Sections 2.0 €“ 4.0 of the policy reads:
2.0 In a combined crew configuration on scene, the PCP may attend to any patient:
- 2.1. who, at the point of transport, does not require the initiation of treatment beyond the PCP scope of practice; or
- 2.2. who, prior to transport, has not received treatment beyond the PCP scope of practice; or
- 2.3. who is improving after receiving treatment included in the PCP scope of practice; or
- 2.4. situations where treatment beyond the PCP scope of practice is not anticipated.
3.0 The PCP with expanded scope and certified in auxiliary medical directives MUST attend any patient when the patient has received, requires, or is anticipated to require an intervention or treatment requiring the expanded scope of the auxiliary medical directives.
4.0 The PCP with expanded scope and certified in auxiliary directives transferring care to a PCP:
- 4.1. The PCP with expanded scope and certified in auxiliary directives will not perform auxiliary medical directives of expanded scope and then transfer patient care to a PCP crew for transportation to hospital unless there are extenuating circumstances. These must be reported through one of the following:
- Online SWORBHP IQEMS self-report form for Paramedic Services currently on the Interdev platform
- Online SWORBHP Communication Form for Paramedic Services not currently on the IQEMS platform
- Via our Self-Reporting Hotline at: 1-888-997-6718