Current through Register Vol. 51, No. 3, September 1, 2024
RELATES TO:
KRS
321.175,
321.190,
321.441,
321.443
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
321.175 and
321.235 establish that the
Kentucky Board of Veterinary Examiners shall protect the public by ensuring
only qualified individuals are allowed to engage in the practice of veterinary
technology in the Commonwealth to promote, preserve, and protect the public
health, safety, and welfare.
KRS
321.441 establishes that a license is
required for veterinary technicians to practice veterinary technology in the
Commonwealth. KRS
321.190(1) establishes that
veterinary assistants may work in the Commonwealth without a veterinarian or
veterinary technician license.
KRS
321.441 and
321.443 establish that licensed
veterinary technicians and veterinary assistants shall be properly supervised
when assisting a veterinarian with the practice of veterinary medicine. This
administrative regulation sets forth the scope of practice for licensed
veterinary technicians (LVTs) and veterinary assistants under various levels of
veterinarian supervision to ensure the safety and welfare of animal patients,
clearly define appropriate roles to be assigned by supervisors, and to provide
confidence in basic care and support for clients.
Section 1. Definitions.
(1) "Direct supervision" is defined by
KRS
321.181(59)(c).
(2) "Immediate supervision" is defined by
KRS
321.181(59)(b).
(3) "Indirect supervision" is defined by
KRS
321.181(59)(d).
(4) "Veterinarian-client-patient
relationship" or "VCPR" is defined in
KRS
321.185.
Section 2. General Provisions.
(1) Supervisors and supervisees are
separately responsible for their own actions pursuant to
KRS
321.190(7).
(2) Except as authorized by
KRS
321.200,
KRS
321.201, and subsection (3) of this section,
the acts of surgery, diagnosis, prognosis, and prescription are limited to a
veterinarian pursuant to
KRS
321.190(6).
(3) Veterinary students enrolled in good
standing in an approved veterinary medical program or veterinary technology
students enrolled in good standing in an approved veterinary technology program
may perform tasks related to curriculum advancement or preparation for a board
approved national exam while under the direct supervision of a veterinarian or
immediate supervision of an LVT.
(4) Persons providing clinical care to
patients shall comply with the medical record keeping requirements established
in KRS
321.187 and 201 KAR
16:701.
Section 3.
Restrictions on the Use of Licensed Veterinary Technicians.
(1) An LVT may perform acts as assigned under
the direction, supervision, and responsibility of a board-licensed veterinarian
who has established and maintains a current veterinarian-client-patient
relationship (VCPR) with the patient and the client in accordance with
KRS
312.185.
(2) The veterinarian and LVT shall comply
with the record keeping requirements established in
KRS
321.187 and 201 KAR 16:701.
(3) The decision about the level of
supervision required by an LVT shall be at the discretion and professional
judgement of the supervising veterinarian if:
(a) The supervising veterinarian is confident
in the level of training and trust in the LVT; and
(b) The tasks assigned to the LVT are not
otherwise prohibited by KRS Chapter 321 or 201 KAR Chapter 16 and comply with
all state and federal laws.
Section 4. Patient Emergency Care Provided by
LVTs.A supervising veterinarian in emergency care situations may assign to an
LVT under indirect supervision, through verbal communication or in accordance
with the supervising veterinarian's written protocols, the following tasks
until the veterinarian is available on the premises to take over treatment:
(1) Application of tourniquets or pressure
procedures to control hemorrhage;
(2) Application of appropriate wound
dressings in severe burn cases;
(3)
Resuscitative oxygen procedures;
(4) Anti-seizure treatment;
(5) Supportive treatment in heat prostration
cases;
(6) Administer drugs to
control pain and shock; or
(7)
Initiate and perform CPR and provide immediate post resuscitation care,
including:
(a) Administration of medication;
and
(b) Defibrillation according to
protocols established in writing at the veterinary facility.
Section 5. Restrictions
on the Use of Veterinary Assistants.
(1)
Pursuant to KRS
321.443, a veterinarian may employ a
veterinary assistant and assign work at the discretion of the supervising
veterinarian, except for those tasks identified in subparagraph (2) of this
section, if:
(a) The veterinary assistant is
under the direction, supervision, and responsibility of a board-licensed
veterinarian, who has established and maintains a current
Veterinarian-Client-Patient Relationship (VCPR) with the patient in accordance
with KRS
321.185;
(b) The tasks assigned to the veterinary
assistant are at all times:
1. Under the
supervision of a veterinarian at a minimum supervisory level as established in
subsections (3) through (5) of this section; or
2. Under the immediate or direct supervision
of an LVT;
(c) The
supervising veterinarian or supervising LVT is confident in the level of
training and trust in the veterinary assistant and their ability to competently
and safely perform assigned tasks; and
(d) The tasks assigned to the veterinary
assistant comply with all state and federal laws.
(2) A veterinary assistant shall not be
assigned the following tasks:
(a)
Surgery;
(b) Diagnosis;
(c) Prognosis;
(d) Prescription;
(e) Euthanasia; or
(f) Tooth extractions of any kind.
(3) A supervising veterinarian or
LVT may assign to a veterinary assistant the following tasks under immediate
supervision:
(a) Regional anesthesia,
including paravertebral blocks, epidurals, local blocks;
(b) Fluid aspiration from a body cavity or
organ, known as centesis; or
(c)
Small animal reproductive ultrasound, and semen collection.
(4) A supervising veterinarian or
LVT may assign to a veterinary assistant the following tasks under direct
supervision:
(a) Unless prohibited by state or
federal regulation, the administration, preparation and application of
treatments prescribed by a veterinarian, including:
1. Controlled substances; and
2. Enemas;
(b) Maintenance and recovery tasks following
veterinarian or LVT administration of general anesthesia and
sedation;
(c) Non-emergency
endotracheal intubation and extubation;
(d) Imaging, including at a minimum:
1. Computed tomography (CT);
2. Magnetic resonance imaging
(MRI);
3. Radiography;
4. Ultrasonography;
5. Fluoroscopy; and
6. Administration of radio-opaque agents or
materials;
(e) Floating
equine teeth;
(f) Ocular tonometry,
Schirmer tear test, and fluorescein stain application; or
(g) Tasks at the discretion of the
veterinarian, which are not in contravention of
KRS
321.190,
321.181(50),
321.443, and this administrative
regulation.
(5) A
supervising veterinarian may assign to a veterinary assistant the following
tasks under indirect supervision:
(a) Unless
prohibited by state or federal law, the administration, preparation, and
application of treatments prescribed by a veterinarian, including:
1. Drugs;
2. Medications;
3. Biological and immunological
agents;
4. Collection of blood;
and
5. Collection and preparation
of cellular or microbiological samples by skin scrapings, impressions, or other
non-surgical methods;
(b)
Intravenous catheterization and maintenance;
(c) Collection of urine by voided
sample;
(d) Monitoring, including
at a minimum:
1. Electrocardiogram
(ECG);
2. Blood pressure;
and
3. CO2 and blood oxygen
saturation;
(e) Clinical
laboratory test procedures;
(f)
Handling and disposal of biohazardous waste materials;
(g) Implantation of a microchip;
(h) Laser therapy;
(i) Animal rehabilitation therapies;
or
(j) Suture and staple
removal.
Section
6. Patient Emergency Care Provided by Veterinary Assistants. A
supervising veterinarian in emergency care situations may assign to a
veterinary assistant who they employ and who is under the veterinarian's direct
supervision, through verbal communication and in accordance supervising
veterinarian's written protocols, the following tasks:
(1) Application of tourniquets or pressure
procedures to control hemorrhage;
(2) Application of appropriate wound
dressings in severe burn cases;
(3)
Resuscitative oxygen procedures;
(4) Anti-seizure treatment;
(5) Supportive treatment in heat prostration
cases;
(6) Administration of drugs
to control pain and shock in accordance with state and federal laws;
or
(7) Initiation and performance
of CPR and performance of immediate post resuscitation care, including:
(a) Administration of medication;
and
(b) Defibrillation according to
protocols established in writing at the veterinary facility.
STATUTORY AUTHORITY:
KRS
321.235(2)(b) 3.c.,
321.441(3)(b)
