# Help me get my drugs!



## med109 (Mar 2, 2013)

We keep our narcs, 12 and 14 gauge needles, and IO gun inside the rig in a locked cabinet. When you enter the back of the rig from the side door, immediately to the right is where we keep the heart monitor and larger gear bags, above that is a locked cabinet that flips up to open. It is locked with a keypad code lock. Punch in the code, turn the handle, and pull the other handle on the cabinet, and it opens.

Today, I had a patient who needed pain meds and the cabinet would NOT open! We have tried everything and can't get it open. I think the latch is bent. Now, how do I fix it? Someone mentioned removing the hinge to take the door off, but it has a piano hinge, so we can't remove the hinge. 

SO, any ideas? ALL of the narcs are in this cabinet. I thought about calling the manufacturer, but medtec is no longer in buisness. So any help would be great!


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## Anjel (Mar 2, 2013)

Umm... Call your supervisor? And take the rig out of service?


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## DesertMedic66 (Mar 2, 2013)

Anjel said:


> Umm... Call your supervisor? And take the rig out of service?



+1. Take the rig out of service and take it to the mechanic or if absolutely nessassry break the cabinet or lock..


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## DeepFreeze (Mar 2, 2013)

med109 said:


> We keep our narcs, 12 and 14 gauge needles, and IO gun inside the rig in a locked cabinet. When you enter the back of the rig from the side door, immediately to the right is where we keep the heart monitor and larger gear bags, above that is a locked cabinet that flips up to open. It is locked with a keypad code lock. Punch in the code, turn the handle, and pull the other handle on the cabinet, and it opens.
> 
> Today, I had a patient who needed pain meds and the cabinet would NOT open! We have tried everything and can't get it open. I think the latch is bent. Now, how do I fix it? Someone mentioned removing the hinge to take the door off, but it has a piano hinge, so we can't remove the hinge.
> 
> SO, any ideas? ALL of the narcs are in this cabinet. I thought about calling the manufacturer, but medtec is no longer in buisness. So any help would be great!



Call a supervisor, take the bus out of service...then call the fire department/locksmith (the fire department loves breaking stuff)

Edit: Any update?


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## mycrofft (Mar 2, 2013)

If it affects chain of custody (controlled substances) use your management and get anything else in writing (if they tell you to just carry it, or fix it yourself).


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## Hunter (Mar 2, 2013)

med109 said:


> We keep our narcs, 12 and 14 gauge needles, and IO gun inside the rig in a locked cabinet. When you enter the back of the rig from the side door, immediately to the right is where we keep the heart monitor and larger gear bags, above that is a locked cabinet that flips up to open. It is locked with a keypad code lock. Punch in the code, turn the handle, and pull the other handle on the cabinet, and it opens.
> 
> Today, I had a patient who needed pain meds and the cabinet would NOT open! We have tried everything and can't get it open. I think the latch is bent. Now, how do I fix it? Someone mentioned removing the hinge to take the door off, but it has a piano hinge, so we can't remove the hinge.
> 
> SO, any ideas? ALL of the narcs are in this cabinet. I thought about calling the manufacturer, but medtec is no longer in buisness. So any help would be great!


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## med109 (Mar 2, 2013)

Im not trolling, and I am serious. I am the manager, and this is our only rig. It looks like this is the lock http://www.kaba-ilco.com/kaba-acces...cal-Pushbutton-Locks/292904/simplex-9600.html.

No update, the cabinet is still locked shut.


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## Veneficus (Mar 2, 2013)

med109 said:


> Im not trolling, and I am serious. I am the manager, and this is our only rig. It looks like this is the lock http://www.kaba-ilco.com/kaba-acces...cal-Pushbutton-Locks/292904/simplex-9600.html.
> 
> No update, the cabinet is still locked shut.



call the FD, ask them to bring "the irons" because you cannot get in a door.

Of course you might want to just drill the lock.


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## abckidsmom (Mar 2, 2013)

Veneficus said:


> call the FD, ask them to bring "the irons" because you cannot get in a door.
> 
> Of course you might want to just drill the lock.



Drilling the lock is going to be the least destructive thing overall.


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## med109 (Mar 2, 2013)

I should add, once you enter the code, you turn the handle to open. This handle keeps turning! You can turn it all the way around the the original position. It does this if you turn the knob right or left!


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## Veneficus (Mar 2, 2013)

abckidsmom said:


> Drilling the lock is going to be the least destructive thing overall.



I know, but I do so love irons.


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## STXmedic (Mar 2, 2013)

As everybody has said several times, just force it open. Drill it or pry it. Then fix the door afterwards.

Edit: See if your local FD has a rabbit tool. They should be able to get in pretty easily and quickly with it.


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## STXmedic (Mar 2, 2013)

Veneficus said:


> I know, but I do so love irons.



I prefer the Denver with a halligan; slightly more versatile


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## Veneficus (Mar 2, 2013)

PoeticInjustice said:


> I prefer the Denver with a halligan; slightly more versatile



I am old school.


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## reaper (Mar 2, 2013)

How about thinking like a manager. Call a lock smith to open it. Not ask random strangers on a forum.

A lock smith will know exactly where to drill to pop the lock, without damaging the door. Saving the company hundreds in repairs.


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## abckidsmom (Mar 2, 2013)

reaper said:


> How about thinking like a manager. Call a lock smith to open it. Not ask random strangers on a forum.
> 
> A lock smith will know exactly where to drill to pop the lock, without damaging the door. Saving the company hundreds in repairs.



That's crazy.  Don't do it.  Get a 12 pound sledge.  Who needs fire?


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## Veneficus (Mar 2, 2013)

abckidsmom said:


> That's crazy.  Don't do it.  Get a 12 pound sledge.  Who needs fire?



Go large or go home, get some fire works and try to blow it.


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## med109 (Mar 2, 2013)

reaper said:


> How about thinking like a manager. Call a lock smith to open it. Not ask random strangers on a forum.
> 
> A lock smith will know exactly where to drill to pop the lock, without damaging the door. Saving the company hundreds in repairs.



Thanks for the oh so valueable piece of advice, I DID call MANY lock smiths. About half of them didn't answer, nor have they returned my call. The ones who did answer, wouldn't come this far on a Saturday. I have to wonder how much it would cost for a lock smith to come (after hours emergency) 100 miles round trip. 

As a manager, I thought of ideas to fix the issue, none of them have worked, so I decided to think outside the box. I hoped there may be another ambulance somewhere in the world who may have had a similar issue and would have some advice.


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## Aidey (Mar 2, 2013)

What is more important, getting the lock box open, or how much a lock smith is going to cost? There are limited options for getting into the cabinet without destroying it.


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## Veneficus (Mar 2, 2013)

A bit off topic, but if you are that far out in the boonies, why do you even need to lock things in a cabinet?


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## NomadicMedic (Mar 2, 2013)

Veneficus said:


> A bit off topic, but if you are that far out in the boonies, why do you even need to lock things in a cabinet?



Are you serious? Do you advocate just keeping the narcs on a shelf?

C'mon. I know you like to be the voice of opposition in threads, but "why do you need to lock things up?" is just ridiculous.


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## Veneficus (Mar 2, 2013)

n7lxi said:


> Are you serious? Do you advocate just keeping the narcs on a shelf?
> 
> C'mon. I know you like to be the voice of opposition in threads, but "why do you need to lock things up?" is just ridiculous.



No its not, I have worked for services that have locked things, services that didn't, and also services where you wore your narcs on your belt. 

If you are in an area where you are constantly out of your vehicle with largely unrestricted access to it, then a lock isn't a bad idea. Of course locking the whole vehicle isn't a bad idea. 

But honestly, in suburbs or rural areas where access is limited, and you are actually taking your equipment with you when you go to a patient, what really is the point of adding a lock?

The only time I have ever seen narcs stolen in any environment, it was from employees.

I have heard of a few reports of crews being threatened for them, and let's be honest, if somebody threatens you for drugs, just hand them over, it is not worth the fight. Hell, I'd even give them the needle and the syringe too.


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## NomadicMedic (Mar 2, 2013)

Sure, I agree that handing over the narcotics in a theft is a good idea,and I don't disagree with keeping your narcs on your person... but c'mon, when referring to storing controlled substances, making a statement like yours, "why do you even need to lock things in a cabinet" is pretty silly. Obviously this guy's system has a policy in place that says something like, "narcotics will be locked in a cabinet". He's not asking if he should change the policy, he's asking for ideas on how to open the door...

And since we've taken this off topic, lets get back to it.


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## med109 (Mar 2, 2013)

Aidey said:


> What is more important, getting the lock box open, or how much a lock smith is going to cost? There are limited options for getting into the cabinet without destroying it.



Cost isn't an issue at all. The other poster implied that calling a locksmith would be cheaper than destroying it, At this point IF I could get a locksmith to come, it probably wouldn't be any cheaper than forcing my way into the cabinet. SO I came here to see if there were any better ideas than destroying it.

Even though we are rural we still have to follow state laws for narcs, which is to lock them up


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## Veneficus (Mar 2, 2013)

med109 said:


> Cost isn't an issue at all. The other poster implied that calling a locksmith would be cheaper than destroying it, At this point IF I could get a locksmith to come, it probably wouldn't be any cheaper than forcing my way into the cabinet. SO I came here to see if there were any better ideas than destroying it.
> 
> Even though we are rural we still have to follow state laws for narcs, which is to lock them up



You got to do what you got to do.


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## DrParasite (Mar 3, 2013)

med109 said:


> Cost isn't an issue at all.


and yet, you wondered what the cost would be to bring a locksmith out on the weekend....

do you only have one ambulance?  if not, switch into the back truck.  take it OOS (due to mechanical reasons), and have the locksmith show up on monday, using the backup with spare equipment over the weekend.

if you only have one, downgrade it to BLS, and mutual aid a paramedic unit from you neighbor.

at midnight on saturday night is not the time to be dealing with the issue that requires a locksmith, unless you have no other option.

and if you do have no other option, than expect to pay a whole lot of money, but if you need the service, it won't be cheap.


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## Christopher (Mar 4, 2013)

DeepFreeze said:


> Call a supervisor, take the bus out of service...then call the fire department/locksmith (the fire department loves breaking stuff)



It is a lesser known fact of the fire service, but you are allowed to call them at all hours of the day/night if it involves them breaking something without getting in trouble. This is almost as popular as bringing the station cookies or other food products.


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## Christopher (Mar 4, 2013)

med109 said:


> Even though we are rural we still have to follow state laws for narcs, which is to lock them up



Hell State laws aren't the bigger issue, behind two locks is what you need for the schedule narcs.

That being said folks could keep them on their person going forward.

We've adopted keyed cabinets with smaller "valuable safes" inside the cabinet. They're a good balance of regulatory requirement and common sense.

1. If somebody wants your drugs, they'll get your drugs.
2. If you try to make it very hard for folks to get to your drugs, you'll invariably keep yourself out of your drugs.

And you lock up your IO gun? We keep that in our house bag. Same with CPAP. Those are the sort of things you would rather have with you when you need them...


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## Tigger (Mar 4, 2013)

Christopher said:


> And you lock up your IO gun? We keep that in our house bag. Same with CPAP. Those are the sort of things you would rather have with you when you need them...



I was wondering about that as well. Seems like I/O is more likely to be needed for something other than narc administration. Even without an IV, I have heard (and seen) IN Fent work quite well.


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## mycrofft (Mar 4, 2013)

see next post


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## mycrofft (Mar 4, 2013)

Go to the pharmacy or whoever supplies your meds and buy some more to tide you over, get hold of the locksmith or the people who sold you this thing for advice..

And make a backup plan for when this happens again.


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## Handsome Robb (Mar 4, 2013)

Veneficus said:


> A bit off topic, but if you are that far out in the boonies, why do you even need to lock things in a cabinet?



Pretty sure the DEA requires double locking of narcotics if they aren't on your person.

FWIW I have a personal digi-lock code assigned to me that works in every ambulance then there's another small metal lockbox inside the cabinet.









Tigger said:


> Even without an IV, I have heard (and seen) IN Fent work quite well.



Lies! Never seen it work the way I wanted it to.


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## usalsfyre (Mar 4, 2013)

Robb said:


> Pretty sure the DEA requires double locking of narcotics if they aren't on your person.


Nope. Just that they're secure behind a single locked door. Straight from a DEA diversion specialist mouth they have no idea where that one came from.


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## Handsome Robb (Mar 4, 2013)

usalsfyre said:


> Nope. Just that they're secure behind a single locked door. Straight from a DEA diversion specialist mouth they have no idea where that one came from.



Must be a company policy then. They always used the DEA as an excuse!


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## DesertMedic66 (Mar 4, 2013)

Robb said:


> Must be a company policy then. They always used the DEA as an excuse!



Same with us


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## NomadicMedic (Mar 4, 2013)

firefite said:


> Same with us



I'll third that. Everywhere I've worked has specified double locked controlled substances, they all cited DEA as the reason.


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## usalsfyre (Mar 4, 2013)

http://www.deadiversion.usdoj.gov/21cfr/cfr/1301/1301_75.htm

Current DEA regulations for practitioners (which is where we fall if your following the correct set of regs)


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## Veneficus (Mar 4, 2013)

usalsfyre said:


> http://www.deadiversion.usdoj.gov/21cfr/cfr/1301/1301_75.htm
> 
> Current DEA regulations for practitioners (which is where we fall if your following the correct set of regs)



Cmon, you know how it works in EMS, if some is good, more must be better.


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## NomadicMedic (Mar 4, 2013)

Veneficus said:


> Cmon, you know how it works in EMS, if some is good, more must be better.



It's seems to be one of those "I heard it somewhere" rules that morphed into policy. However, each state does have specific restrictions. New Jersey, for example. 
(NJAC 8:41-6.3(c) :

"All substances identified in Schedules I through V of the New Jersey Controlled Dangerous Substances Act (N.J.S.A. 24:21-5 through 8.1) shall be kept under a double lock system that requires two separate keys for access, except when under the direct control of an ALS crewmember responsible for their custody."

But at the end of the day, if it is a  department or company policy, the point is moot. They want two sets of locks, they get two sets of locks.


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## mycrofft (Mar 4, 2013)

My last employer was DEA audited becuase of excessive shortages and oit was no fun for the bosses. TGhe staff were woefully ignorant and afterwards reverted back to their slothful ways until automated meds dispensing came in.

Two locks between the narcs and the staff not actually working with them at the time was what we were told. Now, our employer had interpreted that to be the door to the room the narcs were in (locked facility, everytbhning locked) plus a locked box or cabinet. DEA said locked box in a locked cabinet, could not be in a cabinet  open to the room.
I did a thread about how field folks carry tgheir narcs once and it was eyeopening. Many said they signed for narcs at start of shift and carried them around, sometimes literally, then signed them back in.
(facepalm)
(sigh)


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## socalmedic (Mar 4, 2013)

mycrofft said:


> Many said they signed for narcs at start of shift and carried them around, sometimes literally, then signed them back in.
> (facepalm)
> (sigh)



I have done this, nothing wrong with it. in fact it was kinda handy as I always had my narcs within arms reach. I can tell you time from contact to pain management was much shorter.

my current system has them locked in a cabinet in the ambulance.


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## mycrofft (Mar 5, 2013)

Nothing wrong until something goes missing. 

Take my word for it.


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## mycrofft (Mar 5, 2013)

PS: I was wrong, I did not start a thread about narc control systems.


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## emt11 (Apr 21, 2013)

In my system we carry 2 different "drug bags"(we'll call them that for this purpose). One stays on the truck, it has your mag, epi 1:10, sodium bicarb, etc. The other, stays in the jump bag. That one has D50, epi 1:1, narcan, glucagon, haldol, and the narcs. Basically, its where if we leave the truck the narcs have now become an open source to anyone that wants a nice red backpack from the back of an ambulance, and we don't always bring our jump bags in on calls because we run with a ALS FD that usually responds with 1 BLS engine 3-4 FF/EMTs and a ALS rescue 1 FF/Paramedic and 1 FF/EMT. Their theory of sending 2 units and between 5-6 people not including the ambulance which in my system is always ALS with 1 EMT and 1 Paramedic is beyond me but that's another story.


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## blindsideflank (Apr 23, 2013)

we carry belt pouches. one pouch with 4 ampules of morphine, 4 of fentanyl and  2 vials  of versed.

the other pouch (that your partner carries) has ketamine 

our kits and car have our paralytics unprotected (is that normal?)

Canada...


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## usalsfyre (Apr 23, 2013)

blindsideflank said:


> our kits and car have our paralytics unprotected (is that normal?)



Why would you lock them up?


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## blindsideflank (Apr 23, 2013)

^^^ i wasnt sure if they were controlled. I should probably know. Hate to see someone steal the biggest vial in the kit  (succs). Now if we left the narcan laying around...
I was just curious to see what others were doing, with all these safes and what not. Maybe im sensitive to the idea of someone paralyzing themselves to death, probably wouldnt be a good way to go. (plus its MY job to do that to people).

i guess its the issue of which drugs are classified as high risk of abuse, not controlled because, thinking about it more, lots of our meds sit free in the car and kit that are definitely not available over the counter.


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## STXmedic (Apr 23, 2013)

Lol I'd love to see someone break in and shoot up with Vec :lol:


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## NomadicMedic (Apr 23, 2013)

There's been a story floating around for years about somebody who broke into the truck and stole the RSI box. twenty minutes later, same medic unit gets a call for an unconscious/unresponsive. Roll up to find the patient on the ground, not breathing, a vial of succinylcholine on the ground next to them.

I doubt it's a true story, but I hear it every six months or so.


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## RocketMedic (May 9, 2013)

PoeticInjustice said:


> Lol I'd love to see someone break in and shoot up with Vec :lol:



"You'll never catch me running!"


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## Carlos Danger (May 9, 2013)

DEmedic said:


> There's been a story floating around for years about somebody who broke into the truck and stole the RSI box. twenty minutes later, same medic unit gets a call for an unconscious/unresponsive. Roll up to find the patient on the ground, not breathing, a vial of succinylcholine on the ground next to them.
> 
> I doubt it's a true story, but I hear it every six months or so.



Somewhere I read a story about an anesthesiologist who accidentally injected himself with succinylcholine, thinking it was an opioid. 

Don't know if that specific story was true, but I'd be surprised if someone, somewhere hasn't shot up an NMB.


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