Ems Ops Bulletin 5 Flashcards
The controlled medication program establishes methods for managing medications that are classified by the ____ as controlled medications on schedules __,___,___.
DEA
II, III, and IV
Instead of the phrase, “controlled substance”, DC fire will substitute the phrase ___
controlled medication
Controlled Medications are covered by the _____?
Controlled Substances Act.
CMID
Unique number created by DCFEMS for each individual dose of controlled medication.
Controlled medications use and restock log
Shall be updated anytime numbered break away seal on a medication box is opened, replaced, exchanged, etc. Used for pt use, preparation but not used on a pt, breakage.
Controlled medication Tracking Card
card utilized for tracking the transfer, use, and reverse distribution of controlled medications on field units
Controlled meds station safe inventory verification form
form used by EMS supervisors to track and document inventories in the station safe
Patient Care controlled medication inventory tracking form
used to document the inventory, changes in numbered break away seals, transfer of custody of controlled meds between personnel at relief of duty. Creates the audit trail!
CMPO
Controlled Medication Program Officer
Who has a copy of the barrel key?
DFC Ops
If a key is misplaced, is must be located within what time frame?
within 2 hours or change of shift
When changing over apparatus, does the key go with the officer or stay with the apparatus?
Stay with the apparatus.
If a medic unit is downgraded to a BLS unit, does the key get transferred to the officer or stay with the unit and passed along at shift change?
Passed along and accounted for at shift change
What purpose does swiping a key fob serve even if it will NOT open a station safe?
Serves as a witness to the safe being opened.
Who signs the controlled medication station safe inventory form?
just an officer, just an ems supervisor, officer and ems supervisor, Ems supervisor and medic?
C and D
The transfer of custody of medications and barrel key should be done: at 0700, verbally between officer and ems supervisor, or face to face?
Face to face
Transfer of custody is acceptable and inventory documentation requires: signatures from two parties, the off-going medic, the oncoming officer, or on-coming EMS supervisor
signatures from both parties
01 denotes what drug, concentration?
Morphine - 10mg in 1 mL
02 denotes what drug, concentration?
Midazolam - 10mg in 10 mL
03 denotes what drug, concentration?
Midazolam - 10mg in 2 mL
05 denotes what drug, concentration?
Fentanyl Citrate - 100mcg in 2 mL
01-12-1234
example of CMID numbering sequence
the third and fourth number indicate what?
the year the drug was introduced into the system
The final four digits indicate what?
the inventory control numbers for that medication and dose.
Can CM boxes be carried in the ALS bag routinely?
NO
Can carpujet, 3cc syringe, MAD devices be carried in the CM box?
NO
What happens if the apparatus is not capable of providing sufficient power to supply the security system?
It will completely disable the safe.
If a BLS unit is requested by law enforcement or security officials to open the safe for screening, are they required to do so? If so, how?
yes, contact nearest battalion supervisor to assist.
Can unused waste product of CM be used on a second pt?
NO
Where must unused medication be kept after use?
In the custody of the paramedic or secured in the assigned ALS unit safe.
If the security wrapper is breeched in preparation for use on a pt but not used, what shall occur?
The ENTIRE container shall be processed returned as residual waste product.
If a container is broken while on a call, what are other members required to do?
Submit special reports that address what they were doing at the time of the breakage and what they witnessed.
Where is the CM tracking card placed?
In the secondary side pouch of the CM return bag or rubber banded to the CM return bag
Should MAD’s be placed in the CM box when returned?
No.
Can members responsible for controlled medications leave their duty assignment if they have not signed the form to transfer drug custody?
No, unless relief is at an extended fireground operation and the off going member is not available.
If an ALS provider is continuing work into the next shift, does he need to complete the CM box inventory tracking form?
Yes, with the oncoming company officer as the witness
Do both members need to be physically present for the transfer of custody to occur?
YES
Do both members need to swipe key fob’s for transfer of custody of the CM drugs?
Yes - it creates an audit trail
If the unit is getting downgraded from ALS to BLS, who can sign in place of an oncoming ALS provider?
a company officer or EMS supervisor
Who shall secure the barrel key for the apparatus in the absence of an ALS provider?
Company officer
Who should be notified to secure barrel key if an ems supervisor is going out of service? If they are unavailable, who is notified?
BFC - EMS Operations, DFC OPs Aide
If switching to a reserve apparatus and it does not have a fully functional safe, what action should be taken?
CM Box, CM return bags, and Controlled meds log book are to be removed and transferred to the battalion office with a station safe closest to companies quarters.
If the CM box is out of the apparatus safe and due to an apparatus issue (MVC) the apparatus and ALS provider are incapacitated, what shall the first officer do upon making contact with the incapacitated member?
Secure: the controlled meds, controlled med return bags, and the barrel key.
If a company is to remain downgraded for the remainder of the shift, where does the CM box get secured?
Station Safe until the next ALS provider assumes duty.
If a discrepancy is found in the CM boxes, where will they be secured?
In the vehicle safe, access will be denied until an official investigation is conducted.
If there is a discrepancy found, who is required to remain in the station until given permission by an on duty BFC or higher ranking official? A) ALS provider, B) Officer and ALS provider, C) ALS provider, Officer, EMS supervisor, D) All personnel
All personnel
The station safe shall be opened with 2 parties at all times except for who?
restocking by the CMPO
Members that are present for an inventory count but not signing for custody of meds should sign the form how?
Their initials with the words “witness” beside it.
Can hospital personnel exchange or resupply controlled meds?
No.
What 3 medication stores may be used to restock ALS Controlled meds?
Battalion EMS supervisor apparatus safes
Battalion station safes
Via the CMPO
If an ALS unit without controlled meds is dispatched to a call possibly requiring them, can that unit dispatch a second unit with CM on board?
yes, but not until fully assessing the pt first.
If the transport time to the hospital is less than the ETA of the requested ALS provider with the CM, what should the transport unit do?
Transport without delay
How will units status themselves when opening a CM safe or CM box?
“Delayed”
If resupply is occurring at a station safe, how many members need to swipe their key fobs?
2 - the EMS supervisor and ALS provider
EMS supervisors shall submit routine inventory reports and restocking requests to the CMPO when?
On the Monday of the 2nd and 4th week of each month
All reordering and purchases of controlled medications shall be on form what?
DEA Form 222.
How often does the EMS supervisor inventory the station safe?
Daily
Can CM be stored in the special event equipment lock boxes at E24?
No. they are stored in the special event apparatus safe and SP OPS Battalion safe.
Where does the exchange of CM boxes occur for special events?
Quarters of Engine 4
In the case of a broken medication, who will complete the Controlled Medication Preliminary Investigation Report?
EMS supervisor and or respective BFC
Who is responsible for completing all the forms and records associated with the exchange of CM?
EMS supervisor
For an MVC involving dept. apparatus and the apparatus needs to be towed, what happens to the CM and barrel key?
CM’s removed, secured in reserve apparatus or station safe, barrel key paired with apparatus ignition key and sent with apparatus to FMD.
For an MVC involving dept. apparatus and apparatus disabled and ALS provider incapacitated, what actions occur?
Dispatch EMS Supervisor to obtain CM with officer, execute form 1 to document transfer, barrel key with disabled apparatus.
Who is dispatched for a broken medication?
EMS supervisor
