A medical assistant-certified shall be deemed competent by the delegating health care practitioner prior to administering any medication authorized in this section. Medications must be administered under a valid order from the delegating health care practitioner and shall be within the delegating health care practitioner's scope of practice. The order must be in written form or contained in the patient's electronic health care record.

(1) Medication administration shall not be delegated when:

(a) The medication may cause life-threatening consequences or the danger of immediate and serious harm to the patient;

(b) Complex observations or critical decisions are required;

(c) A patient is unable to physically ingest or safely apply a medication independently or with assistance; or

(d) A patient is unable to indicate awareness that they are taking a medication.

(2) To administer medications, the delegator shall ensure a medical assistant-certified receives training concerning: Dosage, technique, acceptable route(s) of administration, appropriate anatomic sites, expected reactions, possible adverse reactions, appropriate intervention for adverse reaction, and risk to the patient. The delegator must ensure a medical assistant-certified is competent to administer the medication.

(3) A medical assistant-certified is prohibited from administering:

(a) Schedule II controlled substances, chemotherapy agents, or experimental drugs; or

(b) Medications through a central intravenous line.

(4) Except as provided in subsection (1) of this section, a medical assistant-certified may administer controlled substances in schedules III, IV, and V or other medications when authorized by the delegating health care practitioner. Medications shall be administered only by unit or single dosage or by a dosage calculated and verified by a health care practitioner. For the purposes of this section, a combination or multidose vaccine shall be considered a unit dose. A medical assistant-certified shall only administer medications under the level of supervision based on the route as described in subsection (5) of this section.

(5) A medical assistant-certified may only administer medications by the following medication category, route and level of supervision:

(6) A medical assistant-certified may:

(a) Start an intravenous line for diagnostic or therapeutic purposes under the immediate supervision of a health care practitioner;

(b) Interrupt an intravenous line and restart at the same rate under the immediate supervision of a health care practitioner;

(c) Administer intravenous injections for diagnostic or therapeutic agents under the direct visual supervision of a health care practitioner; and

(d) Administer intramuscular injections for the purposes of treating a known or suspected syphilis infection without immediate supervision if a health care practitioner is providing supervision through interactive audio or video telemedicine technology in accordance with RCW 18.360.010 (12)(c)(ii).