Standing orders under state law
Does North Dakota law let a medic push scheduled drugs on standing orders, the way the DEA rule assumes?
- Status
- Yes
- Citation
- N.D. Admin. Code 33-36-04-05; 61-09-01-01
- Detail
- North Dakota EMS professionals practise under patient care standards their credentialing physician sets by protocol, and the pharmacy board's ambulance rule assumes controlled substances are carried and given on that footing with the medical director reviewing afterwards.
Partly supported
The scope-of-practice rule describes protocol-based practice without naming controlled substances or saying in terms that the physician need not be present, hence partial support. The same sentence pattern repeats for every level in 33-36-04, and the rule adds that a local medical director may narrow, but never widen, the department's scope. The controlled-substance half of the picture comes from the Board of Pharmacy: N.D. Admin. Code 61-09-01-01 has ambulance services carrying schedule II, III and IV controlled substances under an accountability system the medical director approves, with all medications administered 'promptly documented on a patient care report, reviewed by the ambulance service's medical director on a monthly basis' — a monthly retrospective review is only coherent if the drugs were given without contemporaneous physician contact.
Source quotation
A paramedic working in a prehospital setting provides medical care with physician oversight. In this circumstance a physician credentials the paramedic and establishes patient care standards through protocol.
ndlegis.gov · State administrative code