If a prescribed medication is not on the EMS cart, who should you contact for an exception?

• A. Medical direction
• B. Pharmacy assistant
• C. The patient
• D. The hospital administrator

Answer: (A)

In EMS practice, any medication that isn’t already stocked on the cart requires authorization from medical direction before you give it. The physician or medical control provides online oversight and can issue a specific order for the exception, or guide you to a safe alternative, ensuring dosing, indications, and contraindications are appropriate for the patient’s condition. The hospital pharmacist can advise on drug details, but they don’t grant field authorization. The patient or hospital administrator aren’t the sources for EMS in-field medication approvals. So when a prescribed drug isn’t on the cart, you contact medical direction to obtain the proper exception and instructions.