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Medical Assistants Who Start IV Lines

Many debates revolve around what a medical assistant can do. Among these issues is whether medical assistants are allowed to 
start and disconnect IV lines, insert urinary catheters, administer Botox® injections, take x-rays, or conduct phototherapy in an UV booth. It is imperative to understand that starting or discontinuing an IV line is a highly skilled invasive procedure. The concern is that these highly technical and invasive medical procedures carried out by a non-qualified health care worker can lead to serious consequences if they  injured a patient.

Medical Assistants and IV Therapy

Revised CAAHEP standards and guidelines for Medical Assisting Educational Programs indicate that the curriculum of an accredited medical assistant training program must now include the principles of IV therapy. According to the AAMA website, a medical assistant is only then allowed to place an IV line, initiate an IV line and administer IV medications (only!!!)
after having received PROPER training and only as permitted by their pertaining state laws (check your State Medical Examiner/State Medical Board statutes). Most State Medical Boards/Boards of Medical Examiners rule that only licensed professionals and clinicians are allowed to start and discontinue IV therapy lines on patients, these are typically physicians, specially licensed technologists, i.e. Emergency Medical Technologist (EMT), LVN/LPN, Registered Nurse (RN), Nurse Practitioner, or Physician Assistant (PA). Some states may simply mandate that a medical assistant with such responsibilities must be certified by their facility or via an approved IV therapy program.
Exmples of what medical assistants can do
Please Note: the information contained on this page is provided for information purposes only and should not be considered legal advice, nor is it a substitute or interpretation of regulations established by authorities having jurisdiction over practicing doctors, nurses and their medical assistants in your state. Please contact your State Board of Medical Examiners directly for specific advice, official business, or consult with your attorney. We cannot provide this information to you.

Initiate Intravenous Infusions (IV)

A medical assistant may be asked to assemble intravenous therapy equipment and monitor, or inform a patient about an upcoming IV therapy procedure,
however, before initiating or discontinuing an IV line it is extremely important to first check state specific laws and regulations to be certain this is allowed. Furthermore, although medical assistants were taught principles of IV therapy they are NOT allowed to access, flush and withdraw blood from an Implanted Venous Access device (port-a-cath) often used for cancer patients, esp. in children.

Medical Assistants and Urinary Catheters

Recently, in a discussion in our medical assistant web forum, we learned that an unsuspecting medical assistant was reprimanded and suspended because she was asked to insert an indwelling urinary catheter.

In urinary catheterization ("cathing" for short), a latex, polyurethane, or silicone tube known as a urinary catheter is inserted into a patient's bladder via the urethra. Catheterization allows the patient's urine to drain freely from the bladder for collection. It may be used to inject liquids used for treatment or diagnosis of bladder conditions. The catheter may be a permanent one (indwelling catheter), or an intermittent catheter removed after each catheterization.
A clinician, often a nurse, is allowed to perform this and although patients also self-catheterize, only a few states allow medical assistants to perform this procedure since it is considered invasive. Among the numerous risks are blood infection (sepsis) and urethral injury. Again it is extremely important to check specific laws and regulations in your state.
  • In Alaska: Under Alaska's Statute and Administrative Code properly trained and certified medical assistants are allowed to insert urinary catheters and they can start IV tubing. They also are allowed to administer medications as ordered into an IV under the direction of a physician.
  • In California: California state law requires all medical assisting personnel that draw blood have California DHS approved phlebotomy technician certification. Medical assistants may not place the needle or start and disconnect the infusion tube of an IV.
  • In Idaho: Medical assistants can administer injections, but cannot initiate IV therapy (can take an IV certification course to do so).
  • In Pennsylvania: Pennsylvania medical assistants cannot start an IV.

When will this confusion end? Any questions about the legal principles discussed in this article should be directed to AAMA Executive Director and Legal Counsel Donald A. Balasa, JD, MBA at dbalasa@aama-ntl.org or call (312) 899-1500.

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