NMBOP: 16.19.24 EMERGENCY MEDICAL SERVICES – DANGEROUS DRUGS

Question 1

“Emergency Medical Service”

Answer 1

“EMS” refers to an organization which: transports patients and/or in which patient care is delivered off-site primarily by mobile units in which one or more licensed practitioners assesses or diagnose and treat patients; and in which drugs are stored, distributed, dispensed, or administered for patient treatment.

Question 2

“In Use”

Answer 2

means when dangerous drugs and controlled substances are removed from the principle place of business’ stored inventory and placed in jump kits or mobile units for emergency use.

Question 3

“Jump Kit”

Answer 3

means portable carrying devices that contain emergency medical supplies and drugs.

Question 4

“Location”

Answer 4

refers to any sites which are part of the EMS’s operations, including its headquarters, stations, vehicle bays, docks, or hangers. This can include the mobile units or the practitioner’s jump kits.

Question 5

“Medical Director”

Answer 5

means a physician who is responsible for all aspects of patient care of an EMS

Question 6

“Mobile Unit”

Answer 6

“Mobile Unit” means to a vehicle such as an ambulance, rescue or fire truck; boat or ship; or aircraft.

Question 7

“Practitioner”

Answer 7

“Practitioner” refers to a licensee under the laws and regulations who is an employee or contractee of an EMS and is authorized to assess or diagnose patients, and to dispense drugs for emergency treatment. They may include physicians, physician’s assistants, nurses, and/or emergency medical technicians/paramedics.

Question 8

“Principle Place of Business”

Answer 8

refers to any site’s which are part of the EMS’s operations, including its headquarters, stations, vehicle bays, docks, or hangars where dangerous drugs and/or controlled substances are stored, but does not include dangerous drugs or controlled substances “in use”.

Question 9

MEDICAL DIRECTOR: Shall

Answer 9

A. The Medical Director shall specify the dangerous drugs to be used in such service.

B. The Medical Director shall develop protocols for use of medical procedures and dangerous drugs.

Question 10

Q: What must an EMS obtain in order to purchase and stock controlled substances?

Answer 10

A: In order to purchase and stock any controlled substance, the EMS must obtain separate Drug Enforcement Administration (DEA) and state of New Mexico controlled substance registrations, which are to be issued under the name of the service.

Question 11

Q: What is required of an EMS regarding a consultant pharmacist?

Answer 11

A: Any EMS licensed by the Board is required to have a consultant pharmacist as defined in 16 NMAC 19.4.11.

Question 12

Q: What are the responsibilities of the consultant pharmacist?

Answer 12

A: The consultant pharmacist shall:

1. Review all instances in which controlled substances were used, and review all or a sample of instances in which other drugs were used, at least every 90 days;
2. Report in writing any exceptions to the Medical Director and the chief executive within 24 hours upon learning of the exceptions;
3. Make a written report to the Medical Director and chief executive at least annually on the EMS’s drug handling practices, including corrective action taken on exceptions;
4. Ensure that such reports are available for review by the Board upon request.

Question 13

Q: What policies and procedures must the consultant pharmacist develop for the EMS?

Answer 13

A: The consultant pharmacist will develop policies and procedures for the EMS regarding:

1. Functions of the consultant pharmacist;
2. Formulary;
3. Security of drugs;
4. Equipment;
5. Universal precautions;
6. Licensing;
7. Drug storage;
8. Packaging and repackaging;
9. Distribution records;
10. Document use of expired drugs for training;
11. Administration and/or patient care records;
12. Storage of drugs in jump kits;
13. Drug destruction and records;
14. Drug and device procurement;
15. Receipt of drugs and devices;
16. Delivery of drugs and devices;
17. Designate items to be included in jump kits, define par levels of drugs, storage conditions, and locations where the jump kits are in use.

Question 14

Q: How must dangerous drugs be stored by EMS?

Answer 14

A: All dangerous drugs must be stored with appropriate security to limit access when authorized personnel are not present. Extra precautions shall be provided for the security of controlled substances.

Question 15

Q: Where should jump kits be stored when not in use?

Answer 15

A: Jump kits shall be:

1. Kept in the possession of a licensed emergency practitioner or in a locked compartment of a mobile unit when not in use;
2. Stored in the facility if the mobile unit is parked outside of a secure vehicle bay.

Question 16

Q: What conditions must be met for drug storage?

Answer 16

A: Drugs shall be stored in an area that provides proper ventilation, lighting, and temperature controls as specified by the drug manufacturer.

Question 17

Q: How should outdated or adversely exposed drugs be handled?

Answer 17

A: Drugs that are outdated or have been exposed to adverse conditions shall be segregated from the inventory and held for disposition by the consultant pharmacist.

Question 18

Q: What are the requirements for EMS drug administration?

Answer 18

A: EMS drug administration shall be limited to drugs currently authorized by scopes of practice for EMS personnel. Each licensee shall provide a formulary to the Board on an annual basis or as changes occur.

Question 19

Q: What information must be recorded for the administration of dangerous drugs by EMS?

Answer 19

A: EMS shall keep an up-to-date record in a readily retrievable format indicating:

1. Date of administration;
2. Name of patient;
3. Drug name and dosage administered;
4. Name of the physician responsible for the order, if by other than the Medical Director’s protocols;
5. Name of EMS personnel administering the drug or drugs.

Question 20

Q: How should SCHEDULE II controlled substances records be handled?

Answer 20

A: SCHEDULE II controlled substances administration and receipt records must be kept separately from other drug records.

Question 21

Q: How should SCHEDULE III - V controlled substances records be maintained?

Answer 21

A: SCHEDULE III - V controlled substances receipt and administration records may be kept in the same record as other dangerous drugs, provided a mechanism is used to identify these records (such as a red “C” marked in the margin of these entries).

Question 22

Q: What is the retention period for drug receipt and administration records?

Answer 22

A: All drug receipt and administration records must be readily retrievable and retained for a period of at least three years.

Question 23

Q: What are the requirements for EMS training facilities?

Answer 23

A:

1. EMS Training facilities must be licensed by the Board.
2. Pre-licensing inspections and fees for licensure will be waived.
3. EMS Training Facilities will conduct periodic (no less than quarterly) inventories of dangerous drugs.
4. Other than sections 16.19.24.14.1 NMAC and 16.19.24.14.3 NMAC, other requirements regarding EMS will not apply to these training facilities.