Securing medications

[ffemt101986]

My fire department is in the process of going ALS non transport and as a member of the EMS committee we're trying to develop a way to secure drugs in the apparatus as well as how document when narcotics are used and wasted. I'm looking for the opinions of people already operating this way.

 

[Ewok Jerky]

Double locked in a lock box inside a locked cabinet.

Use and waste is documented on a little slip with patient name, run number, vial number and witness signature. Turned in to a supe as spin as is reasonable after use.

 

[usalsfyre]

It does NOT have to be double locked. That's a mistake made by looking at the wrong regulation.

Do you have your licensing with the DEA and possibly state squared away? You have to hold separate licenses besides your EMS license to administer controlled substances.

Personally I would get in touch with your local DEA field office to make sure everything is squared away. Having been through an audit, you don't want to find out you've been doing it wrong.

 

[Angel]

Double locked in a lock box inside a locked cabinet.

Use and waste is documented on a little slip with patient name, run number, vial number and witness signature.

same where i work. some places make you turn in the empty vials (i assume to verify it wasnt tampered with)

 

[DesertMedic66]

same where i work. some places make you turn in the empty vials (i assume to verify it wasnt tampered with)

Or to verify that a provider actually gave the medication.

There was a FF/medic in a city close to where I live who would refill the morphine vials with saline and then glue the tips back on and switch them out with new vials.

 

[Clare]

Morphine and fentanyl are drawn from the station controlled drug safe at the beginning of the shift and carried in a small belt pouch.

Replacements are drawn as required.

At the end of the shift the pouch is handed to the on-coming shift if there is a person on it with authority to administer controlled drugs or it is locked back in the safe.

Disposing of unused morphine is down the drain or sink and the other Officer witnesses it.

As far as documentation we have a controlled drug register that we fill in, a sample might look something like this

1/11/2014 Total in safe (weekly count) 6 ampoules
1/11/2014 4 ampoules signed out by Clareamedic; 2 ampoules in safe
1/11/2014 1 ampoule used and 1 replacement drawn by Clareamedic; 1 ampoule in safe
2/11/2014 4 ampoules signed over to Otherambo; 1 ampoule in safe
2/11/2014 Incoming order of morphine - total 10 ampoules - 11 ampoules in safe
2/11/2014 4 ampoules signed in by Otherambo - 15 ampoules in safe
3/11/2014 4 ampoules signed out by Clareamedic - 11 ampoules in safe

Response capable vehicles (such as Territory Manager, Shift Supervisor, Clinical Development - i.e. not ambulances) have a controlled drug safe in them and they are, for controlled drug purposes, either "attached" to a station drug safe and restock from that safe (e.g. Clinical Development attach to Mt. Wellington station) or they are treated the same as a station safe and have their own register specific to that vehicle.

Pretty logical and straightforward and it works pretty well.

 

[FiremanMike]

My fire department is in the process of going ALS non transport and as a member of the EMS committee we're trying to develop a way to secure drugs in the apparatus as well as how document when narcotics are used and wasted. I'm looking for the opinions of people already operating this way.

You need to start with your state pharmacy board for their input. Our state is rather specific on what meds need to be secured and how.