The Commonwealth of Massachusetts
Executive Office of Health and Human Services
Department of Public Health
Office of Emergency Medical Services
2 Boylston Street, 3rd Floor
Boston, MA 02116
(617) 753-7300
Fax: (617) 753-7320

MITT ROMNEY
GOVERNOR
KERRY HEALEY
LIEUTENANT GOVERNOR
RONALD PRESTON
SECRETARY
CHRISTINE C.  FERGUSON
COMMISSIONER	

ADVISORY

TO:		All MA Ambulance Services
FROM:	Jon Burstein, MD, State EMS Medical Director
		Louise Goyette, Director
DATE:	April 12, 2004
RE:	Administration of Medications by Paramedics to Persons Not Being Transported

This is to remind all ambulance services, their EMT-Paramedics, and other interested parties that there is no statute, regulation, administrative requirement, protocol or policy that permits ambulance services to dispatch their Paramedics to administer medications to individuals they are not transporting by ambulance. Additionally, there is no legal authority for a Paramedic to carry out such a role.

The Department is aware that ambulance services are receiving calls to send EMT-Paramedics to such individuals, often people who are incarcerated (either being held at a local police department or at a local jail) and whom the police have found with medications on their person. The ambulance services are being called solely to administer the medication, with no expectation of assessment, other treatment or transportation of the individual to a hospital. 

Under 105 CMR 170.355(A), an ambulance service and its EMTs are obligated to dispatch an available EMS vehicle, to provide emergency response, assessment and treatment in accordance with the Statewide Treatment Protocols AND to transport a patient to an appropriate health care facility, and may not refuse to perform ANY of these three responsibilities. EMT-Paramedics who administer medications without assessing patients and without transporting those patients to hospitals violate the Massachusetts EMS regulations, jeopardize patient safety and expose themselves, and the ambulance services for which they work, to liability.
 
Please distribute this Advisory to all of your EMT-Paramedics and your employees with dispatch functions, and ensure that they comply with all current and applicable rules, regulations, policies and protocols. If you have any further questions, please refer them either to Abdullah Rehayem, Manager, Ambulance Regulation Program, or Tom Quail, RN, Clinical Coordinator.