Hangover Clinics and Paramedics

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Tigger

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And what do you plan to do with this information?

It seems like you have the answer you want.
 

Ewok Jerky

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And what do you plan to do with this information?

It seems like you have the answer you want.
Its a crusade. I would bet OP is either a competitor, disgruntled former employee, or a vengeful ex-spouse. This is a lot of work to go through to present all this on this forum. The regulations that were just posted are annotated.

On topic: I don't know about going into hotel rooms, but a hangover "clinic" could certainly be supervised just the same as an special event with regards to the law. And what to say these "medics" going up to hotel rooms to hang a bag aren't working off established protocols from the medical director, and have a line of communication for med control if needed? Not much different from a private company responding to a private (non 911) call, treat on scene with a refusal by the patient for transport.
 
OP
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Vegas Medical

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I am peripherally involved with EMS in Nevada and have an interest in a concierge medical company here in town. I was hoping to get more information from people on this forum, but nobody really had any good information. I have spent the last month getting the information together.

Yes, if a physician or PA is supervising the MA in person, it is all good.

If the EMT or Paramedic is "clocked in" for a licensed EMS unit, they can do a wide variety of things per their licensing with the appropriate regulatory body.

But, if they are not "clocked in" for a licensed EMS unit, they function as a medical assistant (MA.) An MA can do quite a bit if a physician or PA is supervising them in person. The Nevada regulations do not allow for prescribing or supervision of MAs remotely via phone or otherwise. It must be in person. So, a paramedic or EMT going to a hotel room to give somebody a bag of IV fluid is a Class B felony if a physician or PA does not go with them physically.

People can interpret this thread however they want, but there is clearly quite a bit of confusion. We thought about employing medics in a similar fashion as some of these other operations in town, but decided not to once we did our research. EMS personnel should do their own homework before signing up for one of these other outfits.

This whole "medical director" thing has caused an enormous amount of confusion. A "medical director" is only valid for a licensed EMS unit such as AMR, Medicwest, or similar. For a medical clinic, the term "medical director" means absolutely nothing.

This is a crusade of sorts....to keep people from going to jail.
 

chaz90

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The very same law you posted (NAC 630.820) mentions that remote supervision of a medical assistant is authorized if the delegating practitioner is A. located a significant distance away from the patient or B. Available immediately by phone.

I'm no lawyer, but to me this seems like having the doctor live out of town or carry a phone that he/she can answer anytime during working hours of his medical assistants will fulfill the requirement.

If you don't have some kind of strange crusade against these businesses why are you trying to create problems in what appear to be wholly legitimate and legal services to people who request their services? Perhaps it's just me, but I still can't figure out the point of this thread. You seem to have the information you want separate from the opinions we've provided.

If you are starting a concierge medical business and don't want to hire paramedics, don't. Seriously, hire whoever you want at whatever level of training and pay they require and price your services accordingly. Best of luck with your business endeavors!
 
OP
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Please read the regulation again. It is odd, but it is there in black and white. A medical assistant can be supervised remotely if they are in a "rural area". It specifically states that Las Vegas is not a rural area.

Yes, it is BS that people in rural areas get a different level of healthcare, but governments do not always make laws in a logical fashion.......
 
OP
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Vegas Medical

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And also, in the rural area, the patient has to have been physically seen by a prescribing provider (doctor or PA-C) before anything can happen. The MA can only do things remotely in a rural area for followup visits.
 

Ewok Jerky

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I worked a for a private ambulance service, with a medical director. We did not respond to 911 calls but to private calls from SNFs, offices, private citizens whatever. We also did standbys for parties, concerts, events, fairs, sports, BP clinics, walks, runs whatever. We would often treat on scene and release for all kinds of stuff. We used local protocols. We would transport if needed, wouldn't if it wasn't, and would handle RASs and AMAs just like a 911 ambulance. My medic was well within his rights to start a line, give whatever was indicated, DC the line and release the patient accordingly. I'm not saying this happened often, we weren't running a hangover clinic, but it was certainly legal from an EMS perspective.

I don't see this situation as any different from a medic from a private service fielding a private call to a hypoglycemic crisis, administering d50 through a line, charging for their services and taking off.

Would I want the liability of owning such a business? No. But I do think it is legal in hypothetical sense, not knowing what all the laws are in NV besides the annotated ones you presented here.
 

triemal04

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This is a crusade of sorts....to get rid of my competition.
I went ahead and fixed that for you.
If you are starting a concierge medical business and don't want to hire paramedics, don't. Seriously, hire whoever you want at whatever level of training and pay they require and price your services accordingly. Best of luck with your business endeavors!
Most likely he is trying to start the exact same type of buisness and can't figure out a way to do it as cheaply and easily without using paramedics. And since he can't do that, and is a late comer to a party that already has at least one established group doing it, is now looking for a way to drive them out of buisness/scare off any employees so that he can increase his market share.

Of course that just the most likely explanation...
 
OP
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Vegas Medical

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One of the key issues here is that none of these hydration/hangover clinics have an EMS license. This thread has gotten a bit long and I think that fact got lost in all thread.

Yes, ambulance companies can do all sorts of things with their medics. But, they have an EMS license. These other operations don't and the EMTs and paramedics are putting themselves at high legal risk working for them, as they are only medical clinics, not EMS units.
 

MonkeyArrow

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@Vegas Medical If you're so worried about the legality of such operations, why don't you give the regional health district having jurisdiction over this geographical area a call and see what they say about it? If it was illegal, I am 99.9999999% that it would have already been shut down, judging by the fact that these companies have been featured in the news and advertise. Ask said health officials what licenses they have/need to operate. Make sure to report back to us and let us know what they say.
 

SandpitMedic

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http://www.hangoverheaven.com/in-room-treatments-2/

That there is a link to one of the most popular providers of the service we are talking about. Specifically, a link to the "in room therapy."

@Vegas Medical, can you read the 2nd and 3rd lines of the first paragraph to the jury please?

In case you can't, here is the text:

"At Hangover Heaven, we can treat you in the comfort of your hotel room. We will send our physician, physician assistant, or nurse practitioner to your hotel room, along with an assistant to make sure your treatment is as professional and efficient as possible."

Does this answer your question and/or clearly display the way these companies are doing this legally?

I am a paramedic in Las Vegas. I'd work there per diem, and I know folks that do. There are no issues, and the governing agencies that oversee this type of practice are hard at work ensuring that it is all done on the level.

Rest assured... The only way you'd be able to prove that there was not in fact, a mid level provider present, would be to secretly record the meeting in your room. HOWEVER, since you're such a lawyer you must know that in the great State of Nevada, it is a class D felony (http://www.leg.state.nv.us/NRS/NRS-200.html#NRS200Sec690) to do so without the consent of the parties being recorded in any way.

SO... Good luck in your shady crusade.... Know when to hold 'em and when to fold 'em though.

Quit trying to stir the pot. Just go with the flow. It's VEGASSSS, baby!

And if your intent is not shady, lay all your cards on the table.
 

SandpitMedic

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@MonkeyArrow
He already has been bugging the Health District. They just aren't as interested in it as he is.
 

irishboxer384

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This is all too complex and tedious, it'd be much easier to just lease out the services of some attractive females on the strip
image.jpg
 

triemal04

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Jeebus...this is ridiculous.

Let's be objective for a second. You came here to ask a question...that you already had an answer to. Each time someone pointed out exceptions to your answer you counter with dire threats about what will happen to anyone who does that, up to now including going to jail. You have a financial stake in a buisness that either is, or probably would like to perform the same services as you mentioned in the beginning.

Hmmmm....gee I wonder what could be going on here...:rolleyes:
 

Cdurham0510

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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?
Where can I find a lot of information on this?
 

HardKnocks

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WTF? No one cares about IV nurses, nor your view. This is a seven year old thread that had all the information needed.

You can go now.
Regardless; Your inaccurate data is still in play.

EMT's that have only practices in over-regulated jurisdictions are shocked when EMT-B can legally do in some States , what they cannot as EMT-P or higher.

Example;

Here's a list of Special Skills that a Medical Director can train and sign off an EMT-B in AZ.
AZ EMT Special Skills
 

Jim37F

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Regardless; Your inaccurate data is still in play.

EMT's that have only practices in over-regulated jurisdictions are shocked when EMT-B can legally do in some States , what they cannot as EMT-P or higher.

Example;

Here's a list of Special Skills that a Medical Director can train and sign off an EMT-B in AZ.
AZ EMT Special Skills
CCCSD literally only said "read the 5 year old thread that already has all the answers to the question you (Cdurham) asked"

Why are you jumping down his throat like they said the concept doesn't exist? We're all quite well aware that different jurisdictions have different scopes of practice including ones that let EMTs start IVs and give some meds....

Which has nothing to do with Cdurham's question on Paramedics doing IV for hangovers...
 
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