Section 56 Class Exemption for Technician-Paramedic, Technician-Advanced Paramedic and Aeromedical Attendant in Manitoba

Pursuant to section 56 of the Controlled Drugs and Substances Act (CDSA), paramedics with the title of Technician-Paramedic, Technician-Advanced Paramedic or Aeromedical Attendant in the province of Manitoba employed by Land System or Air Medical Response System licence holders authorized under The Emergency Medical Response and Stretcher Transportation Act (Manitoba) 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 with respect to fentanyl, ketamine, morphine and pethidine
• Subsection 2(1) of the Benzodiazepines and Other Targeted Substances Regulations with respect to diazepam, lorazepam and midazolam

In respect of this exemption,

Controlled substance means one of the following substances: diazepam, fentanyl, ketamine, lorazepam, midazolam, morphine and pethidine.

Medical Director means a person defined as a Medical Director under the Land Emergency Medical Response System Regulation (Manitoba) or Air Emergency Medical Response System Regulation (Manitoba), and who is ultimately responsible for ordering, transporting, storing and providing controlled substances to affected paramedics for a Land System or Air Medical Response System licence holder authorized under The Emergency Medical Response and Stretcher Transportation Act (Manitoba).

Paramedic means a person who is licensed by Manitoba Health under the Land Emergency Medical Response System Regulation (Manitoba) or Air Emergency Medical Response System Regulation (Manitoba) to practice paramedicine as a Technician-Paramedic, Technician-Advanced Paramedic or Aeromedical Attendant, and is authorized by a Medical Director to administer controlled substances as part of the practice of paramedicine.

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.

This exemption provides the aforementioned paramedics with the authority to possess, transport, administer and destroy controlled substances when providing pre-hospital care to patients within their scope of practice as set out in the Manitoba Emergency Treatment Guidelines established by Manitoba 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. Administer the controlled substances in accordance with the relevant protocols established by Manitoba Health;
2. Record all transactions involving controlled substances, i.e., date, name and quantity of controlled substances obtained, administered, returned or destroyed, and provide such a record to the Medical Director for record-keeping purposes;
3. Take necessary steps, in accordance with the guidelines concerning controlled substances established by Manitoba Health, to ensure the security of the controlled substances on their person and in their ambulance or aircraft;
4. Report immediately to their Medical Director when they become aware of any loss or theft of controlled substances in their possession or in their ambulance or aircraft;
5. Dispose of any unserviceable controlled substances in accordance with the guidelines concerning controlled substances established by Manitoba Health with respect to witness and record-keeping; and
6. Obtain controlled substances only from the Medical Director of the Land or Air Medical Response System licence holder with which they are affiliated.

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 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: September 30, 2010