I was going to reply to Mr. Shamards email with this but I though I would post it here first. As with all the other COG changes this one has also been meet with confusion, I think this is something that needs to be addressed.

Thanks
Keith

I was hoping someone could clarify this further for me as I have had a few discussions with other employees. I understand each agency has 60 days to prepare and implement the new changes, from June 1, but we do not work under medial standing orders from the agency we work for. I / we work under orders from Dr. Racht and the way I understand it the changes have been made, effective June 1, although we may or may not have the correct medications and tools to make those changes. For example: LR has been removed from the COG’s. Therefore, even though it is still on the trucks we would have to call and get orders to use it. Or the new changes state continuous NTG, are we able to this now without calling for orders? Is the web page on the OMD’s web site an official change of standing medical orders? This is very confusing and could possibly get someone into some trouble.