Opinion letter to Barrett A.

..JOHN ASHCROFT ATTORNEY GENERAL ~z!l~¥~ POST OFFICE BOX 899 JEFFERSON CITY, MISSOURI 65102 June 22, 1983 (314) 751-3321 OPINION LETTER NO. 11-83 Barrett A. Toan, Director Department of Social Services Post Office Box 1527 Jefferson City, Missouri 65102 Dear Mr. Toan: (corrected) You have requested our legal opinion on the following question: Is a hospital employed Mobile Emergency Medical Technician authorized to perform the procedures delineated in Section 190.140 RSMo. in a hospital emergency room when so directed by a physician or a registered nurse? Section 190.140, RSMo 1978, reads in its entirety: Notwithstanding any other provision of sections 190.100 to 190.195, mobile emergency medical technicians may do any of the follow- ing at the scene of the accident in an ambulance or at the emergency room of a licensed hospital: (1) Render rescue, first-aid and resuscitation services; (2) Perform cardiopulmonary resus- citation and defibrillation in a pulseless, nonbreathing patient; (3) During training at the hospi~al and while caring for patients in the hospital administer parenteral medications under-the direct supervision of a physician or a registered nurse; and II Barrett A. Toan, Dlrector (4) Where voice contact or a telemetered electrocardiogram is monitored by a physician or a registered nurse authorized by a physi- cian, and direct communication is maintained, mobile emergency medical technicians may upon order of such licensed physician or such licensed registered nurse do any of the following: (a) Administer intravenous saline or glucose solutions; (b) Perform gastric suction by intubation; (c) Perform endotracheal intubation; and (d) Administer parenteral injections of any of the following classes of drugs: a. Antiarrhythmic agents; b. Vagolytic agents; c. Chronotropic agents; d. Analgesic agents; e. Alkalinizing agents; f. Vasopressor agents; and g. Other drugs which may be deemed necessary by such ordering physician; (5) Deliver emergency medical care to the sick and injured while in the emergency department of a licensed hospital and until care responsibility is assumed by a licensed physician or a licensed registered nurse. We interpret Section 190.140 to authorize mobile emergency medical technicians to take the actions described in clauses (1) and (2) in a hospital emergency room without supervision or direction from a physician or registered nurse, and to take the actions described in clause (4) in a hospital emergency room when in direct comr,mnication with, and ordered to do so, by a physician or a duly authorized registered nurse. We understand clause (5) to mean that mobile emergency medical technicians can render emergency medical care in a hospital emergency room without supervision or direction by a licensed physician or a licensed registered nurse until such time as a physician or registered -2- Barrett A. Toan, Director nurse assumes care responsibility for the patient directly relieving the mobile emergency medical technician of responsibility for attending a patient. Very truly yours, ~t~~r~- JOHN ASHCROFT Attorney General -3-