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PCP Transport Following ACP Narcotic Administration

Question #45

Can a Primary Care Paramedic (PCP) remain with their original patient and continue transport after an Advanced Care Paramedic (ACP) administers opioid analgesia, assuming the patient has had good effect, does not require further dosing, and the transport is short? Historically, we have treated this as out-of-scope for PCPs, requiring the ACP to take over the call. Has this changed with version 5.4 of the ALS PCS, or was this addressed in CME?

Answer:

Yes, a PCP may continue care during transport after administration of opioid analgesia by an ACP, but only if there is clear justification that no further analgesia will be required. Examples include short transport times where a second dose would not reasonably be given, or if the patient has explicitly declined further dosing. Pain that is currently managed may not remain that way, especially on longer transports. Therefore, this handover is only appropriate when it is clinically reasonable to expect that no further opioid administration will be necessary during transport.

Medical Directive Category

Analgesia

Published

15 July 2025

ALSPCS Version

5.4

Views

20

Please reference the MOST RECENT ALS PCS for updates and changes to these directives.