Legal issues uk

[Medicine Man]

Somebody asked me recently about the legality of non-medics carrying and administering injectable medicine in the Uk.

It is not illegal to possess any Prescription only Medication (POM) unless it is a controlled drug which applies to strong opiate pain killers, street recreational drugs, tranquilizers and some steriods. (See Misuse of drugs act 1971 and 2001)

However getting them in the first place is far more strictly controlled.

It is illeagal to administer most injectable drugs unless you are a medic, however there are some useful exceptions.

A non medic can only give Prescription only Medicices(POM) drugs in article 7 of the POMS (Human Use) act which covers all the following,

Adrenaline Injection 1 in 1000 (1 mg in 1 ml)
(Anaphylaxis and Severe Asthma)

Atropine Sulphate Injection
(organophosphate poisoning, Nerve Agents and Slow Heartbeats)

Chlorphenamine Injection
(antihistamine, Allergies, anaphylaxis)

Glucagon Injection
Glucose Injection 50%
(Hypogycaemia in Diabetes)

Hydrocortisone Injection
(anaphylaxis)

Naloxone Hydrochloride
(Heroin or morphine overdose)

Promethazine Hydrochloride Injection (antihistamine, Allergies, anaphylaxis)


Snake Venom Antiserum


The Following at Nerve Agent Antidotes
Atropine sulphate and obidoxime chloride injection
Atropine sulphate and pralidoxime chloride injection
Atropine sulphate, pralidoxime mesilate and avizafone injection
Pralidoxime chloride injection
Pralidoxime mesilate injection
Sterile Pralidoxime

The Following at Cyanide Antidotes
Dicobalt Edetate Injection
Sodium Nitrite Injection
Sodium Thiosulphate Injection

[smileyt]

So basically in life-saving emergencies non-medics can administer injectable drugs? Presumably for many of the above drugs (such as for allergies and anaphylactic shock) the patient would be carrying something like an epipen?

[Moony]

Is it not the case that english common law and 'Good Samaritan Law' mean that provided you act in good faith, particularly in a life threatening situation, anyone can carry out any sort of medical procedure, whether qualified or not ? If you break someones ribs while giving chest compressions / CPR, no english court would convict you of assault. Similarly, if you inject someone with something that ends up killing them, provided you can prove you were genuinly trying to help that person (and with their consent if they are able to give it) you would probably avoid conviction ?

Don't take the above to mean I don't think your first port of call should always be properly trained medical professionals, but the rules on what is legal / illegal is, like in so many spheres, open to interpretation in a court of law.

[jansman]

So basically in life-saving emergencies non-medics can administer injectable drugs? Presumably for many of the above drugs (such as for allergies and anaphylactic shock) the patient would be carrying something like an epipen?

My Wife is trained in epi- pen administration, and has to be re-trained every 6 months. she tell me if you get it wrong, that person could lose the limb( leg I believe) that pen was stuck into. I really do think you need ro know what you are doing

[Medicine Man]

To clarify
You can only legally administer injectables on the list.

The good Samaritans act dose not exist its a concept not a law but you must act within your scope of practice. So CPR example is fine but probably not giving wrong drugs.

You should always seek professional help and be trained of at all possible. But in an emergency anyone can do it legally.

It's to save life so any unfortunate mishap is incidental If a life is saved

[Moony]

Thanks for that clarification medicine man, if travelling abroad people should be aware that the Good Samaritan Law is legally enforable in some countries (notably France, some others too I believe). This means you are committing an offence by not offering assistance by someone who is injured, this assistance should be in line with your ability to render it. So if you have no 1st Aid training you will at least be expected to call 999 (er 112 even), simply walking past and ignoring someone is a criminal offence.

The effect of this legal situation was brought to my attention when a friend of mine was involved in a serious bike accident near one of the French ports last year, the french drivers who came on the scene immediately came to give assistance, called ambulance, got first aid kits from the car, kept the victim warm and protected the area from other vehicles...while every single British car simply drove on past and ignored the incident. If one had stopped with a good french-speaking passenger it would have helped a lot as the victim (in shock) had very poor french and was having trouble communicating with his french rescuers !

[Medicine Man]

Interesting much like the duty of care health professionals have in the uk

[bhakta]

Presumably you can only administer the prescribed item to the person its prescribed for ?

Prescriptions are for named persons?

Some drugs make perfect sense for a non medic to administer e.g glucagon to your hypoglycaemic diabetic spouse.

But in what situation is a non medic going to give atropine ?

Some of the drugs listed can be given by simple intramuscular injection ( 20 minutes training) but others require intravenous adminstration another level of training altogether.

Not sure that Dextrose 50% should be on the list, how exactely is that going to be given safely without dilution and IV access?
Perhaps 20% ?

[Appin]

I have been told that a genuine legal defence for breaking the law is that a worse crime would occur if you did not act. Also the courts have a history of being kind to those who genuinely thought they were doing their best ( and being harsh with bluffers and phonies EG bogus paramedic wannabes).

I agree with Medicine Man as I understand it you can carry any POM including controlled drugs IF they have been prescribed for you. Possession of a POM without prescription would be an illegal supply issue but controlled drugs it is a possession offence.

Most of the drugs in that list are covered under what are known as "Patient Groups Directives" . These are designed to allow nurses and paramedics who have knowledge and training in when and how to use the drugs to act alone if a life is at risk and is the basis of paramedics giving drugs. The act also allows for administration independently if a major disaster is in progress.

http://webarchive.nationalarchives.gov. ... /index.htm

http://webarchive.nationalarchives.gov. ... DH_4069610

Epi - pens are interesting the general view from the allergy specialists is to encourage anyone to have a go. The trick is to read the instructions VERY VERY carefully as if you do it wrong you will inject your own thumb and potentially cause gangrene. ( The end the needle comes out of is not obvious in some types of pen).

50% Glucose used to be the standard for hypo diabetics. You can just inject into a vein. Problem is the vein tends to get very inflamed afterwards. If I was a hypo diabetic I'd rather have a sore vein than stay hypo. The other advantage is you only need 50mL of 50% so it is less bulky to carry.

Regards

Appin

[Medicine Man]

Atropine could be used for a life threatening bradycardia but I think in this instance it's meant for nerve agent antidote.

Well spotted re glucose I certainly wouldn't recommend a mon medic using glucose as if you missed the vein you would be In danger of making the limb necrotic