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What do you carry in your narcotics safe?
How much of each?
What concentration?
What do you wish you had or what would you get rid of?
How are your guidelines? Do you feel you can adequately manage pain, seizures, agitation etc?
Standing orders, call-in, some of both?
Basically I enjoy talking about how different systems do things, would love to hear how you feel your agency's controlled substances stuff works. Feel no pressure to talk about any of these or in any order.
For me:
Both of my jobs use essentially the same guidelines. The only call in for use of controls is Ketamine admin exceeding 1mg/kg/hr. Fentanyl 100mcg bolus for adult patients, as many times as needed. We are permitted to mix a benzo with fentanyl using half the typical dosing of each. Can treat agitation with valium, versed, and/or droperidol no questions asked. EtCO2 is required for any use of controls, to include a single dose. I find this silly.
Recently we started carrying Dilaudid to have another option with current difficulties with getting Ketamine. I am not sure when I want to use this medication tbh. we can only five it once.
Drug box wise:
FD Job: 4 fentanyl 100mcg/2ml, 3 Versed 5mg/5ml, 2 Valium 10mg/2ml, 1 Ketamine 200mg/10ml. Engines carry half that with no Ketamine.
I would like to carry 5mg/1ml Versed, seems better for IM and IN use. I like having valium, I know its old skool but seems to work nicely for anxiety and skeletal muscle relaxation with fractures and the like.
AMR: 3 fentanyl 100mcg/2ml, 3 Versed 5mg/5ml, 1 Dilaudid 1mg/1ml, 1 Ketamine 500mg/5ml.
Currently we can only use Ketamine for RSI induction. Non-RSI medics do not carry it.
How much of each?
What concentration?
What do you wish you had or what would you get rid of?
How are your guidelines? Do you feel you can adequately manage pain, seizures, agitation etc?
Standing orders, call-in, some of both?
Basically I enjoy talking about how different systems do things, would love to hear how you feel your agency's controlled substances stuff works. Feel no pressure to talk about any of these or in any order.
For me:
Both of my jobs use essentially the same guidelines. The only call in for use of controls is Ketamine admin exceeding 1mg/kg/hr. Fentanyl 100mcg bolus for adult patients, as many times as needed. We are permitted to mix a benzo with fentanyl using half the typical dosing of each. Can treat agitation with valium, versed, and/or droperidol no questions asked. EtCO2 is required for any use of controls, to include a single dose. I find this silly.
Recently we started carrying Dilaudid to have another option with current difficulties with getting Ketamine. I am not sure when I want to use this medication tbh. we can only five it once.
Drug box wise:
FD Job: 4 fentanyl 100mcg/2ml, 3 Versed 5mg/5ml, 2 Valium 10mg/2ml, 1 Ketamine 200mg/10ml. Engines carry half that with no Ketamine.
I would like to carry 5mg/1ml Versed, seems better for IM and IN use. I like having valium, I know its old skool but seems to work nicely for anxiety and skeletal muscle relaxation with fractures and the like.
AMR: 3 fentanyl 100mcg/2ml, 3 Versed 5mg/5ml, 1 Dilaudid 1mg/1ml, 1 Ketamine 500mg/5ml.
Currently we can only use Ketamine for RSI induction. Non-RSI medics do not carry it.