Subsection 56(1) Class Exemption for Advanced Care Paramedics in New Brunswick

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Pursuant to subsection 56(1) of the Controlled Drugs and Substances Act (CDSA), paramedics with the title of Advanced Care Paramedic in the province of New Brunswick 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
• Subsections 5(1) and 5(2) of the CDSA with respect to fentanyl, ketamine and midazolam
• Subsection 3(1) of the Benzodiazepines and Other Targeted Substances Regulations with respect to midazolam

The terms used within this exemption have the same meaning as they do in the CDSA and its regulations except as defined below:

• Ambulance New Brunswick means the agency that provides emergency medical services as licensed by the New Brunswick Department of Health in accordance with the Ambulance Services Act (New Brunswick).
• Approved Designate means a person authorized by a person/title or by specific appointment to take over the responsibilities of the Designated Administrator in their absence.
• Controlled substance means one of the following substances: fentanyl, ketamine and midazolam.
• Designated Administrator means a person who is in a managerial position and is ultimately responsible for ordering, transporting, storing and providing controlled substances for Ambulance New Brunswick.
• Paramedic means a person who is registered by the Paramedic Association of New Brunswick under the Paramedic Act (New Brunswick) to practice paramedicine as an Advanced Care Paramedic.
• 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.
• Vehicle means a vehicle designated as part of the Clinical Service Unit that is used by a paramedic in the course of their professional duties.

This exemption provides paramedics with the authority to possess, transport, provide, destroy, and administer controlled substances when providing pre-hospital and inter-hospital transfer care to patients within their scope of practice as set out in relevant policies by the New Brunswick Department of Health, and subject to the terms and conditions of this exemption.

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

1. Only administer controlled substances in accordance with the relevant protocols regarding the use of controlled substances by the New Brunswick Department of Health, or under the direction of a medical practitioner;
2. Record all transactions involving controlled substances, i.e., date, name and quantity of controlled substances obtained, administered, provided and returned, and provide such a record to their Designated Administrator, or if the Designated Administrator is absent, their Approved Designate, for record-keeping purposes;
3. Take all necessary steps, in accordance with the policies concerning controlled substances established by the New Brunswick Department of Health, to ensure the security of the controlled substances in their possession or control;
4. Report immediately to their Designated Administrator, or if the Designated Administrator is absent, their Approved Designate, when they become aware of any loss or theft of controlled substances in their possession or control or in their vehicle, ambulance or aircraft;
5. Comply with all other applicable reporting requirements, including, for example, those set out in section 69 of the Narcotic Control Regulations. Maintain all records with respect to narcotics in accordance section 69 of the NCR;
6. Dispose of any unserviceable controlled substances by either,
   1. Providing them to a hospital employee or a practitioner in a hospital; or
   2. Providing them to a Designated Administrator, or if the Designated Administrator is absent, their Approved Designate, in accordance with the guidelines concerning controlled substances established by the Ambulance New Brunswick; and
7. Obtain controlled substances only from the Designated Administrator, or if the Designated Administrator is absent, their Approved Designate.

This exemption replaces the "Section 56 Class Exemption for Advanced Care Paramedics in New Brunswick" that was issued on January 31, 2017. This exemption will remain in effect until the date on which this exemption has been replaced or the date on which this exemption is revoked.

A suspension of this exemption without prior notice may be ordered if the Minister deems that such a suspension is necessary to protect public health, safety or security.

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 behalf of the Minister of Health

Original signed by

Michelle Boudreau
Director General
Controlled Substances Directorate
Health Canada

Effective Date: January 31, 2017

Updated on: February 14, 2020