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EMS Scope of Practice: Monoclonal Antibodies and Antiviral Agents

Our EMS and healthcare systems and resources are once again becoming strained due to the increased number of hospitalizations for patients infected with the COVID-19 virus. While vaccination remains the most effective avenue to prevent infection and the need for hospitalization, the administration of monoclonal antibodies to COVID-positive patients exhibiting mild or moderate symptoms without hypoxia or to exposed immunocompromised persons may prevent the need for hospitalization. 

The administration of monoclonal antibodies is within the Ohio EMS scope of practice for the Paramedic level of certification only.  Analogous to all medical services provided and psychomotor skills performed by EMS, the administration of monoclonal antibodies requires authorization from the local EMS medical director. In addition, the local EMS medical director must provide a written protocol, training, continuing education, and a quality assurance program.

The Ohio Department of Public Safety, Division of EMS is providing this information solely as a resource to EMS systems that elect to include this measure within their local EMS protocols. Nationally, EMS systems have administered monoclonal antibodies within congregate residential sites experiencing a COVID-19 outbreak as well as off-site locations in an effort to decompress hospital infusion centers, protect individuals receiving chemotherapy at these facilities, and increase the capacity to treat patients who are eligible to receive monoclonal antibodies for COVID-19 infections.  It is highly advisable for Ohio EMS medical directors who elect to provide monoclonal antibody administration protocols to the Paramedics they oversee to do so in partnership with their local healthcare system and public health agencies. 

Once again, thank you for your dedicated service to Ohio EMS and stay safe!

Carol A. Cunningham, M.D., FAAEM, FAEMS, State Medical Director


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