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IV Therapy Clinics: Take Note of IV Supervision Requirements

As IV therapy clinics become more and more popular, the question to follow is, who can place the IV line and under what supervision? You would expect that first responders like Emergency Medical Technicians (EMT) would be able to start lifesaving IV lines on their own since they are the life support in between an incident and the emergency room. Contrary to what one might think is an “appropriate” ability or function of emergency personnel, under Florida law, EMTs are actually not permitted to place their IV lines on their own outside of an emergency situation. While there might be some very narrow exceptions, the general rule is clear in its prohibition.

The scope of practice for Emergency Medical Services (EMS) personnel (defined by Florida Statute 401.23) provides, that there are two levels of practice for EMS: basic life support (BLS) and advanced life support (ALS). The main difference is that ALS allows for “the administration of drugs or intravenous fluids” to patients while BLS does not.

Furthermore, there are four licensing levels for EMS personnel: Emergency Medical Responder (irrelevant for the purposes of IV and this article); EMT (also sometimes referred to as EMT-B or Basic EMT); Advanced EMT (AEMT); and Paramedic. EMTs, AEMTs, and Paramedics are all qualified to perform BLS, but only Paramedics are fully qualified to perform both BLS and ALS.

Florida Code summarily states that an EMT may place a non-medicated IV line if they’ve been sufficiently trained (subject to the ALS provider’s medical director) prior to the event and are directed and supervised by the ALS provider (almost always a Florida Certified Paramedic) to do so.

Here is what the code specifically says:

(h) An EMT employed by a licensed ALS provider is authorized to start a non-medicated IV under the following conditions:

  1. A non-medicated IV is initiated only in accordance with department approved protocols of the licensed ALS provider’s medical director. These protocols must include a requirement that the non-medicated IV be initiated in the presence of a Florida certified paramedic (of the same licensed provider) who directs the EMT to initiate the IV.
  2. If the licensed ALS provider elects to utilize EMTs in this capacity, the licensed EMS provider shall ensure that the medical director provides IV Therapy training deemed sufficient by the medical director. The licensed EMS provider shall document successful completion of such training in each EMTs training file and make documentation available to the department upon request.

While EMTs might be prohibited from working in an IV therapy clinic, there might be two types of EMS personnel that might be able to: AEMTs and Paramedics. AEMTs are qualified to start and administer non-medicated IV fluids, while Paramedics are qualified to provide full ALS, which includes administration of drugs or IV fluids in the entirety. This still requires a deeper evaluation due to the complexity of the statutes, however. For more information, you can contact our office for a free consultation.