Hangover Clinics and Paramedics

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Vegas Medical

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I have seen some hangover clinics here in Las Vegas that are using paramedics to give IV treatments for hangovers. My understanding is that medics can only give IV meds when working for an EMS unit. Does anybody else know the rules on this?
 

DesertMedic66

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Doesn't have to be an EMS unit. As long as they have a medical director It's normally fine. Even in EMS units paramedics and EMT still have to have a medical director to operate.
 
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Vegas Medical

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That is what some people have said, but the term "Medical Director" only applies to EMS units under the SNHD regulations. A medical clinic is not an EMS unit, so there is no "Medical Director" like there is for an EMS unit. The whole thing is a bit confusing, but even in hospitals, I have seen medics being able to start IV's, but they cannot push IV drugs.
 

Chewy20

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I have seen some hangover clinics here in Las Vegas that are using paramedics to give IV treatments for hangovers. My understanding is that medics can only give IV meds when working for an EMS unit. Does anybody else know the rules on this?

Are they actually giving meds or are they just pushing fluid? Wouldn't see any benefit besides normal saline. If they are, then its possible they are working under a doc who may own the company.

I had a medic talking to me about how he was going to start his own business doing this here in Texas. Don't know why people would waste their money. Saw a story on the news that people were paying this doc $400 per visit for IV therapy for hangovers.
 

chaz90

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I don't know. I imagine if they're offering some electrolyte therapy and anti-emetics it could make people feel a bit better. I don't begrudge these guys the opportunity to make some cash. If hungover adults want to spend $400 bucks a pop for an IV, couple liters of saline, and 4 mg of Ondansetron, more power to the guys earning money. That's capitalism man.
 
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Vegas Medical

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I talked to the folks at the Southern Nevada Health Division, which oversees EMS operations here in Southern Nevada. They told me that EMTs and Paramedics are only licensed to touch patients when they are "clocked in" at a licensed EMS unit, such as AMR, Medicwest, or one of the County Fire Departments, or similar EMS unit. A medical clinic is not an EMS unit.

The people working for the hangover clinics are basically practicing medicine without a license, which is against the law.

I figured this was the case. They also confirmed that the term "Medical Director" only applies to EMS units. If the EMT/Paramedic is not "clocked in" at their EMS unit, then a medical director is not relevant. A medical director only covers their activities when they are working on a rig or special event for their EMS unit.

Things may be different in states other than Nevada, but a paramedic cannot push IV drugs, or even hook up a bag of a saline for a hangover clinic or hydration clinic. Any patient who wants prescription medications has to be physically seen by an MD, PA, or nurse practitioner. A bag of saline is a prescription medication.

The phone number for SNHD EMS is 702-759-1050 if people want to get it straight from the source.
 

DesertMedic66

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call the company and ask. We have some places here who hire paramedics to work in post op centers for them to start IVs and use their ACLS cert if needed. They normally just work under the direction of the MD and their official title is not paramedic.
 

Tigger

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It is possible that they are not working as paramedics. If they are working directly under a doctor and that doctor is willing to take liability for their actions (and their insurance is ok with this), it may be fine. I used to work under a doctor when I did sports medicine in college. While I was an EMT I could do whatever I was comfortable with and trained in by my ATC boss.
 
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Vegas Medical

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That is a good point you bring up. Per the Nevada Medical Board, a "medical Assistant" can do just about whatever the physician trains them to do, so long as the physician is in the building. I can find the Nevada Statute regarding that, but the doc has to be in the building. The problem is these medics are taking Rx meds off to hotel rooms without a physician present. They are "Han Solo" which is not copacetic with the law.
 

Tigger

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I guess I really don't see the issue here...what is your concern?
 

SandpitMedic

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Haha. Han Solo? That's funny.

Soooo... Are you looking to sue someone orrr are you looking for a job? Writing a thesis? An entrepreneur?

If a doctor gives you orders... You're covered; they work under him and are not titled 'paramedics'.

Yes, rich people pay big bucks for specialized services to come to their hotel room and give them fluids, banana bags, zofran, etc...

It's Vegas... Business finds the loopholes to make it legal. They have billboards and adverts. It is widely known. If it was illegal then they would shut it down.

The guys make good tips for the customer service they provide.

Is that completely on the level? I'm not a lawyer. But club hosts, dealers, valets, etc dealing or being the middle man for drugs and prostituion sound like a bigger deal than a trained medical professional providing actual relief from ones after-party symptoms.

Wouldn't you say?
 

Handsome Robb

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I'm confused as to the point of this thread...

I guess what I'm saying is who cares?? They're acting as an extension of the physician and treating patients...

Are you a nurse who's feeling like these Paramedics are impeding on your territory?
 

Carlos Danger

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The people working for the hangover clinics are basically practicing medicine without a license, which is against the law.

No, not necessarily.

I don't know the first thing about Nevada, but many states allow what is called "delegated medical practice", the specifics of which vary by state of course, but which basically means that a physician can train and authorize just about anyone to perform just about any act, as long as the physician supervises and accepts complete responsibility for the individual's training and actions.

Based on my 0.76 second Google search, it looks like Nevada is one of these states. If that is the case, then paramedics doing this may not be practicing under authority of the state EMS agency or an EMS medical director, and still be perfectly legal. In essence, they aren't working as paramedics as all; they are just laypeople that the doctor running the drunk tank hired, trained to administer whatever they're administering, and supervises.

This was the very first result I got when I searched "Nevada delegated medical practice":

"After several abortive attempts by the Board to promulgate medical assisting regulations, the Nevada Legislature took matters into its own hands and passed Senate Bill 294 on the final day of the 2011 session. The bill confirms the authority of medical assistants to possess and administer “dangerous drugs” (i.e., any medication requiring a prescription, other than controlled substances) “at the direction of the prescribing physician and under the supervision of a physician or physician assistant.”5 SB 294 authorized the Board of Medical Examiners and the State Board of Osteopathic Medicine to develop regulations further addressing the delegation of administration of dangerous drugs to MAs (as of this writing, neither board had initiated such rulemaking proceedings). The bill also cre- ates a statutory definition of “Medical assistant”: an unli- censed person who performs clinical tasks under the supervision of a physician, an osteopathic physician, or a physician assistant; and does not include a person who performs only administrative, clerical, executive or other nonclinical tasks."​
 
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SandpitMedic

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Chimpie

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I saw a news story about this a couple months back about a place in Tampa that's doing this. I believe they said the fee was $150.

Edit: $140 + extras

http://www.tampabay.com/news/busine...o-customers-to-cure-fatigue-hangovers/2190146

The HangIVer Bar offers five kinds of IV treatments, or cocktails, which cost about $139 each. Extra doses of Vitamin C, Toradol (a pain killer) and Glutathione (an antioxidant) cost an additional $25 to $30.

Treatments last about 30 minutes and are administered by paramedics from local fire departments who work at the spa part time. The needles are slightly bigger than ones used to draw blood at doctors' offices but smaller than ones for donating blood.
 

Ewok Jerky

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Depending on state regs this is no different than a phlebotomist starting a line. Or Joe Schmoe from of the street hired to be an ER tech or MA after some OTJ training. A lot of these everyday tasks of "practicing medicine" are NEVER performed by docs. In my ED codes are run with the doc standing in the corner with his arms folded directing the team, not physically doing anything. Then the doc sits at the computer and "practices medicine" by clicking on order sets with the mouse. The point is I guarantee there is an MD being paid to supervise and anybody's toes are being stepped on its the nurse's union. But it really doesn't sound like anything shady going on here to me.
 
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Vegas Medical

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If a EMT/paramedic is working outside of a licensed EMS unit, they are a medical assistant. Per Nevada law, a MA can do quite few things if the physician is physically present in the building directly supervising them. This is how medics, etc can place IVs in the ER. An IV catheter is a prescription item by the way, just as is a bag of saline. The problem with what is going on here in Las Vegas is that medics are being sent out to hotel rooms to treat clients for hangovers and the patient is not being physically seen/supervised by a Physician Assistant or Doctor. This is governed by NRS 453.3643 that states that a patient must be physically seen by a midlevel or higher every six months to be directly given a prescription medication or a written prescription. NAC 630.820 states that a MA cannot be remotely supervised.

One person above asked what the point of this thread was and it is to get information together regarding these issues. The result is that if an MA is going out giving prescription medications to a patient who has not been physically seen by a midlevel or higher, they can be found guilty of a Class B felony. 3 years in prison and fines of up to $100,000.

The rules governing this are complex, but the information above is factual straight off the Nevada Government website. I have also contacted the Southern Nevada Health District and they confirmed that Medics are not licensed to do anything other than be a medical assistant outside of their employment at an EMS unit.

I talked to the EMS office in Georgia and the hydration business there has a physician assistant on-site supervising the Medics. That is the key issue is that somebody who holds an actual license to prescribe medications has to physically see these patients. If you want, PM me and I can email you the actual regulations. I did attach them to this post. Not sure how they will show up.
 

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