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Support urged for emergency treatment bill
Letter to the editor


The triage, treatment and transport emergency medical service practitioners provide can often be the difference between life and death for patients with a medical emergency. The unique nature of emergency medical services is unlike other health-care services governed by the Controlled Substances Act. There is a routinely encountered clinical need for controlled-substance medications in the practice of EMS medicine, ranging from the administration of pain narcotics to antiseizure medications. Emergency medical technicians and paramedics need to administer these lifesaving drugs as quickly as they are able to reach and assess the patient, 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, the Department of Justice determined that legislation is needed to codify “standing orders.” Absent congressional action, patients may lose access to those lifesaving medications in emergency situations, and established practice will be disrupted because laws have not kept up with the evolution of medicine.

To remedy this dilemma, U.S. Rep. Richard Hudson, R-N.C., has authored House Resolution 4365, 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 preset protocols, which emergency medical service practitioners follow in delivering emergency medical care. In the absence of standing orders, patients would not have access to the time-sensitive and potentially lifesaving interventions they so desperately need.

H.R. 4365 ensures patients will continue to receive these vital medications by:

• Codifying the practice of standing orders by a physician medical director for the administration and delivery of controlled substances, 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.

This legislation is endorsed by the Air Medical Physician Association, American Academy of Emergency Medicine, American Academy of Pediatrics, American Ambulance Association, American Association of Orthopedic Surgeons, American College of Emergency Physicians, Association of Air Medical Services, Association of Critical Care Transport, Emergency Nurses Association, Epilepsy Foundation, International Association of Fire Chiefs, International Association of Fire Fighters, National Association of EMS Physicians, National Association of Emergency Medical Technicians, National Association of Police Organizations, National Association of State EMS Officials.

Richard Daniels

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