Section 56 Class Exemption for Advanced Care Paramedics, Critical Care Paramedics and Infant Transport Team Paramedics in British Columbia

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Pursuant to section 56 of the Controlled Drugs and Substances Act (CDSA), paramedics licensed in the category of Advanced Care Paramedic, Critical Care Paramedic or Infant Transport Team in the province of British Columbia are exempted for medical purposes from the application of the following provisions of the CDSA and its regulations:

• Subsection 4(1) of the CDSA with respect to fentanyl, ketamine, morphine and pethidine
• Subsections 5(1) and 5(2) of the CDSA with respect to diazepam, fentanyl, ketamine, lorazepam, midazolam, morphine and pethidine
• Subsection 8(1) of the Narcotic Control Regulations (NCR) with respect to fentanyl, ketamine, morphine and pethidine

In respect of this exemption,

• British Columbia Ambulance Service (BCAS) means the agency that bears the name "British Columbia Ambulance Service" and provides ambulance services under the authority of the British Columbia Emergency and Health Services Commission in accordance with the British Columbia Emergency and Health Services Act.
• Controlled substance means one of the following substances: diazepam, fentanyl, ketamine, lorazepam, midazolam, morphine and pethidine.
• Unserviceable controlled substance means a drug product containing a controlled substance that is expired, contaminated, damaged, or any residual controlled substance remaining in a multi-dose vial.
• Paramedic means a person who is licensed as an emergency medical assistant under the British Columbia Emergency and Health Services Act and the Emergency Medical Assistants Regulation in the category of Advanced Care Paramedic, Critical Care Paramedic or Infant Transport Team, and who is authorized under that legislation to administer controlled substances in the course of practising as an emergency medical assistant in the province of British Columbia.
• Designated Pharmacy means a pharmacy that is authorized to operate in the province of British Columbia by a pharmacy licence issued under the British Columbia Pharmacy Operations and Drug Scheduling Act, and whose owner has a contractual agreement with the British Columbia Emergency and Health Services Commission for the supply of controlled substances to paramedics in the province of British Columbia.
• Designated Administrator means a BCAS Medical Director who is ultimately responsible for ordering, transporting, storing and providing controlled substances for a BCAS region, or a physician designated in writing by such a Medical Director to act on his or her behalf for the purposes of this exemption.

This exemption provides the aforementioned paramedics with the authority to possess, transport and administer controlled substances in the course of providing services to patients within their licensed scope of practice under the British Columbia Emergency and Health Services Act and the Emergency Medical Assistants Regulation, in accordance with the direction of a practitioner designated by the BCAS and/or the relevant guidelines established by the BCAS, and subject to the terms and conditions of this exemption.

The exemption is only applicable if the following conditions are met. Paramedics must:

1. Administer all controlled substances in accordance with the direction of a practitioner designated by the BCAS and/or pre-approved guidelines established by the BCAS;
2. Record all transactions involving controlled substances, i.e., date, name and quantity of controlled substances obtained, administered and returned, and provide such a record, in the form and manner required by the Designated Administrator, to a Designated Administrator for record-keeping purposes;
3. Take necessary steps, in accordance with guidelines established by the BCAS, to ensure the security of controlled substances on their person and in their emergency vehicle or aircraft;
4. Report immediately to a Designated Administrator, in the form and manner required by the Designated Administrator, when they become aware of any loss or theft of controlled substances in their possession or in their emergency vehicle or aircraft;
5. Return any unserviceable controlled substances to a Designated Pharmacy, in the manner agreed between the Designated Pharmacy and the Designated Administrator for the BCAS region in which the Designated Pharmacy is located; and
6. Obtain controlled substances only from a Designated Pharmacy, in the manner agreed between the Designated Pharmacy and the Designated Administrator for the BCAS region in which the Designated Pharmacy is located.

This exemption will remain in effect until revoked. Failure to comply with the terms and conditions of this exemption may, among other things, result in immediate suspension of this exemption, and ultimately, in its revocation.

Signed for and on the behalf of the Minister of Health

Diane Allan, Director
Office of Controlled Substances
Controlled Substances and Tobacco Directorate
Healthy Environments and Consumer Safety Branch

Effective Date: April 30, 2010