The triage, treatment, and transport emergency medical service practitioners provide can often be the difference between life and death in a medical emergency. The unique nature of emergency medical services is unlike other health care services governed by the Controlled Substances Act. There is often a clinical need for controlled substance medications in the practice of EMS medicine, ranging from the administration of pain narcotics to anti-seizure medications. Emergency Medical Technicians and Paramedics need to administer these lifesaving drugs as quickly as possible, and any delay wastes valuable time in the provision of care. Established practice allows emergency medical service practitioners to administer and deliver these controlled substances under the oversight of physicians, primarily through directional guidelines written by physicians, commonly known as standing orders.

Laws and regulations have not kept up with the evolution of modern medicine however, and in a recent review of the Controlled Substances Act (CSA), the Department of Justice determined that legislation is needed to codify “standing orders.” Absent Congressional action, patients may lose access to life-saving medications in emergency situations and established practice will be disrupted.

To remedy this dilemma, North Carolina Congressman Richard Hudson has introduced H.R. 4365, and Louisiana Senator Bill Cassidy has introduced S. 2932, the Protecting Patient Access to Emergency Medications Act. This legislation will clarify that the current practice of physician medical directors overseeing care provided by paramedics and other emergency medical service practitioners via “standing orders” is statutorily allowed and protected. The use of “standing orders” is necessary so that physician medical directors can establish these pre-set protocols which emergency medical service practitioners follow in delivering emergency medical care.

In the absence of standing orders, patients will not have access to the interventions they so desperately need. The legislation will ensure patients will continue to receive these vital medications by codifying the practice of standing orders and maintaining physician oversight of medical decisions while making the EMS agency liable for the receiving, storing and tracking of controlled substances, similar to current procedure at hospitals.

Heidi Lincoln-Taylor

Mancos