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Volume 46, No. 13

B.C. Reg. 245/2003

The British Columbia Gazette,

Part II

July 2, 2003

B.C. Reg. 245/2003, deposited June 20, 2003, pursuant to the HEALTH PROFESSIONS ACT [Section 12]. Order in Council 635/2003, approved and ordered June 19, 2003.

On the recommendation of the undersigned, the Lieutenant Governor, by and with the advice and consent of the Executive Council, orders that the Midwives Regulation, B.C. Reg. 103/95, is amended

(

a) in

section 5 (1) by adding the following paragraphs:

(

d) prescribe, order or administer drugs and substances specified in

Schedule 1 to this regulation, and

(

e) order, collect samples for, perform or interpret the results and reports of screening and diagnostic tests specified in

Schedule 2 to this regulation. ,

(

b) in

section 6 (1) by adding the following paragraph:

(

c) consult with a medical practitioner if the result or report of a test in item 4 of

Schedule 2 is abnormal. ,

(

c) in

section 6 by adding the following subsection:

(1.1) A registrant may

(

a) prescribe or administer a substance in item 1 (2) of

Schedule 1 only for intrapartum chemoprophylaxis for Group B Strep,

(

b) prescribe or administer a substance in item 1 (3) of

Schedule 1 only for therapeutic rest in prodromal labour,

(

c) order and administer a drug in item 2 of

Schedule 1 only in emergency conditions and in consultation with a medical practitioner, and

(

d) administer a drug in item 3 of

Schedule 1 only after consulting with and on the order of a medical practitioner. , and

(

d) by adding the attached Schedules 1 and 2. — S. HAWKINS, Minister of Health Planning; J. van DONGEN , Presiding Member of the Executive Council.

Schedule 1

Drugs and Substances

(1) A midwife may prescribe or administer the following substances:

Chloroprocaine — 2%

Clotrimazole

Diphenhydramine hydrochloride — IM

Doxylamine succinate-pyridoxine hydrochloride

Ergonovine maleate

Erythromycin ophthalmic ointment

Hepatitis B immune globulin

Hepatitis B vaccine

Hydrocortisone anorectal therapy compound

Intravenous fluids — normal saline, Ringer's Lactate, 5% dextrose in water

Lidocaine hydrochloride without epinephrine — 1%

Measles / Mumps / Rubella (MMR) Vaccine

Miconazole

Nystatin

Oxytocin — IV or IM injection

Phytonadione

Pre-mixed 50/50 nitrous oxide and oxygen

RhD Immune globulin

Therapeutic oxygen

Triple dye

(2) Subject to

section 6 (1.1) (

a) of the regulation, a midwife may prescribe or administer the following substances:

Ampicillin

Clindamycin

Penicillin G

(3) Subject to

section 6 (1.1) (

b) of the regulation, a midwife may prescribe or administer the following substances:

Lorazepam (oral or sublingual)

Oxazepam (oral or sublingual)

2 Subject to

section 6 (1.1) (

c) of the regulation, a midwife may order and administer the following drugs:

Carboprost tromethamine

Epinephrine hydrochloride

Naloxone hydrochloride

3 Subject to

section 6 (1.1) (

d) of the regulation, midwife may administer the following drugs:

Acetaminophen with codeine

Antibiotics

Antiemetic/sedative agents with narcotic analgesics

Barbiturates

Cervical ripening agents — in hospital only

Sedatives

Epidural analgesia (continuous infusion maintenance) — in hospital only

Narcotic antagonists

Narcotics — in hospital only

Oxytocin intravenous infusion — in hospital only

4 A midwife may order, prescribe or administer any drug or substance that may lawfully be purchased or acquired without a prescription.

Schedule 2

Screening and Diagnostic Tests

1 A midwife may order, collect samples for and interpret the report of the following screening and diagnostic tests:

(

a) for a woman:

(

i) chemistry: blood glucose, urinalysis (routine and microscopic), serum ferritin, Maternal Serum Marker Screening;

(ii) cytology: cervical smears (Pap smears);

(iii) hematology: hemoglobin, hematocrit, white blood cell count with differential, red blood cell morphology, platelet count, sickle cell solubility, fetal blood screen, Kleihauer-Betke and Rosette;

(iv) microbiology:

(

A) cervical and vaginal cultures and smears (including sensitivities if relevant) for Group B streptococcus, gonorrhoea, chlamydia, yeasts, trichomonas, and bacterial vaginosis;

(

B) urine for culture and sensitivities; swabs for culture and sensitivities (e.g. wounds, episiotomies);

(

C) wet preparation (for fungus, trichomonas, parasites);

(

D) viral swabs (e.g. herpes);

(

v) serology/immunology; blood group and type with antibody screen, repeat antibody testing, hepatitis, human immunodeficiency virus antibody, rubella antibody, toxoplasmosis antibody, syphilis serology, cytomegalo virus antibody, HSV antibodies IgG and IgM;

(vi) pregnancy test (blood and urine);

(

b) for a newborn:

(

i) hemoglobin, hematocrit, white blood cell count with differential, blood type and Rh factor, neonatal metabolic screen, glucose, Coombs, and bilirubin;

(ii) microbiology samples: cord and eye, ear, and gastric fluid cultures.

2 A midwife may order, perform and interpret the results of the following screening and diagnostic tests:

(

a) urine (dip stick analysis);

(

b) pregnancy test (urine);

(

c) blood glucose: adult and newborn (stix method);

(

d) hemoglobin (finger prick method);

(

e) ferning test (amniotic fluid);

(

f) non-stress test;

(

g) external fetal monitoring.

3 A midwife may order and interpret the report of an obstetrical ultrasound test.

4 Subject to

section 6 (1) (

c) of the regulation, a midwife may order the following tests for a woman:

(a) 24 hour urine for protein;

(

b) BUN;

(

c) liver function;

(

d) serum creatinine;

(

e) serum electrolytes;

(

f) serum uric acid.

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