Ever been asked by a provider to glue a laceration and felt that knot of uncertainty in your stomach? You’re not alone. This question sits at the intersection of patient care, professional boundaries, and legal liability—and getting it wrong can have serious consequences for your career. The short answer? Generally no, a Certified Medical Assistant cannot glue lacerations unless specific conditions are met.
But understanding those conditions and how to protect yourself professionally is crucial. This guide will give you a clear framework—the Three-Pillar Test—to make confident, safe decisions in your practice.
Understanding the CMA Scope of Practice
Your scope of practice isn’t just a guideline—it’s a legal boundary that defines exactly what you’re permitted to do as a CMA. Think of it like your professional licence’s guardrails. Cross them, and you risk more than just a reprimand.
The scope of practice varies significantly by state, which is where much of the confusion originates. What’s perfectly acceptable in California might be prohibited in New York. State medical boards, nursing boards, and health departments establish these parameters based on training standards and public safety considerations.
Clinical Pearl: Scope of practice is determined by state law, NOT by your employer’s preferences, insurance requirements, or what your supervising provider is comfortable with you doing.
When faced with a procedure question, many CMAs make the mistake of relying on workplace culture or previous experiences in other facilities. This is like driving by memory rather than checking the actual speed limit signs—dangerous and potentially costly.
Why Wound Gluing is Typically Considered an Advanced Procedure
Here’s what many people don’t understand: wound gluing isn’t just an upgraded version of applying a bandage. Medical-grade skin adhesives like Dermabond are medical devices that chemically bond skin edges together. You’re essentially performing a form of wound closure—permanently altering the patient’s tissue integrity.
Imagine this scenario: A patient presents with a 2.5 cm laceration on their forearm. After cleaning the wound, your supervising physician asks you to “quickly glue it” while they handle another emergency. They say, “It’s easy, just like using superglue!” But what happens if the wound reopens, becomes infected, or the patient has an allergic reaction?
Wound gluing typically involves:
- Assessing wound depth and contamination
- Choosing appropriate closure method
- Proper tissue approximation
- Preventing adhesive infiltration into the wound
- Managing potential complications
These steps require clinical judgment and training that goes beyond the standard CMA curriculum. That’s why most states classify this procedure alongside suturing and staple placement—firmly in the advanced procedure category.
The Three-Pillar Test: When Is It Permissible?
Knowing when you can perform wound gluing requires checking three critical pillars. All three must be solid. If even one pillar is missing, the answer should be no.
Pillar 1: Explicit State Law Allowance
First and foremost, your state must explicitly permit CMAs to perform this procedure. This isn’t about what’s “not prohibited”—it’s about what’s specifically allowed. Check your state’s medical board website, professional association guidelines, or scope of practice documents.
Common Mistake: Assuming that because your state allows CMAs to perform “basic wound care,” it includes wound gluing. Most statutes differentiate between basic dressing changes and closure procedures.
Pillar 2: Provider Delegation and Supervision
Even in permissive states, you need explicit delegation from the supervising provider. And we mean explicit—not a casual “Hey, can you handle this?” in a busy moment.
Proper delegation includes:
- Written documentation of the specific task
- Clear parameters for when to seek help
- Direct supervision available during initial procedures
- Ongoing evaluation of your competency
Pillar 3: Documented Training and Competency
This is where many CMAs unknowingly fall short. Being “shown how once” or watching an online video doesn’t qualify. You need documented, competency-verified training.
Proper training should include:
- Formal education program (theoretical and practical)
- Supervised practice sessions
- Competency assessment and documentation
- Periodic skills verification
Pro Tip: Keep your own training portfolio. Document dates, instructors, learning objectives, and competency assessments. This documentation protects both you and your employer.
The Professional and Legal Risks of Overstepping
Let’s be blunt—the risks of performing procedures outside your scope are severe and can permanently damage your career.
Potential consequences include:
- Civil liability: If a patient has a poor outcome, you could be named in a malpractice lawsuit
- Criminal charges: In some states, practicing medicine without a license carries criminal penalties
- Loss of certification: The AAMA can revoke your CMA credential for scope violations
- Termination: Most employers will fire CMAs who create liability risks
- Difficulty finding future employment: Scope violations follow you in background checks
Research published in the Journal of Healthcare Compliance shows that medical assistants face increasing scrutiny from state boards, with disciplinary actions for scope violations rising 35% between 2018-2022.
Key Takeaway: No job is worth losing your certification over. When in doubt, the professional answer is always “no” until you can verify otherwise.
What to Do If You’re Asked to Perform a Questionable Task
You know that moment when you’re asked to do something that doesn’t feel right? Your professional responsibility to question the request outweighs any discomfort you might feel about speaking up.
Here’s a professional script you can adapt: “I want to make sure I’m providing the best care while staying within my legal scope. Can we quickly verify that wound gluing is specifically permitted for CMAs in our state and that I’m properly delegated for this procedure?”
Steps to verify:
- Ask to see your facility’s written policy on CMA procedures
- Request written delegation from the supervising provider
- Check your state’s medical board website immediately
- Document your verification efforts
Clinical Pearl: Good providers will respect your professionalism in verifying scope. If someone pressures you despite your valid concerns, that’s a red flag about the workplace culture.
Conclusion & Key Takeaways
Navigating scope of practice questions requires both knowledge and courage. Remember: default to “no” until you can definitively confirm otherwise through the Three-Pillar Test. Your state law, proper delegation, and documented training must all align before considering advanced procedures like wound gluing. Protect your certification by questioning vague requests and seeking verification in writing. Your long-term career depends on these small but crucial professional decisions today.
Frequently Asked Questions
Can an MA assist a provider while they glue a laceration?
Yes, assisting is generally within scope as long as you’re not performing the actual closure. This may include preparing supplies, positioning the patient, cleaning the wound, and applying dressings after the provider completes the closure.
What’s the difference between skin glue and steri-strips for CMAs?
Steri-strips are typically considered within the CMA scope of practice as they don’t involve chemicals or permanent tissue alteration. Skin adhesives chemically bond tissue and are usually classified as an advanced procedure.
Does insurance coverage affect what procedures I can perform?
No, insurance coverage doesn’t determine your scope of practice. Some facilities may incorrectly state “insurance won’t cover it if a CMA does it,” but the real issue is whether state law permits the procedure at all.
What if my employer says it’s okay because they’ll take responsibility?
Employers cannot legally authorize you to practice outside your scope. You remain personally and professionally responsible for your actions, regardless of what an employer claims.
Have you faced a scope-of-practice question in your practice? Share your experience in the comments below—your story could help another CMA navigate a similar situation!
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