1-16 NARCOTICS AND CONTROLLED SUBSTANCES
Medications utilized in the care of a patient:
When a rescue squad utilizes a medication(s) they may get these restocked at any Inpatient Pharmacy at any Brown County Hospital, regardless of where the patient was delivered. This will be done by presenting to the Inpatient Pharmacy and asking a pharmacist or pharmacist tech to exchange the medication. A Pharmacy Exchange Form will be filled out including Patient Name, Date of Birth, PCR number, and medication being exchanged. A copy of this form should be saved and stored in a locked box at each station. Each EMS agency has their own account on file at the Inpatient Pharmacies of each Brown County Hospital. The medications dispensed will be billed to the agency as per current agreements with the hospitals. The rescue agencies will be required to retain medical records which contain the medication administered for not less than 5 years. A standard run form may serve this purpose if the appropriate medication and dose are noted.
Controlled Substance Exchange: When a controlled substance is utilized in the care of a patient, this will also be exchanged at the Inpatient Pharmacy. A Pharmacy Exchange Form will be filled out including Patient Name, Date of Birth, PCR number, AS WELL AS medication and amount administered, amount (if any) wasted, and the signature of the paramedic requesting the medication exchange. This paramedic will need to have photo ID at the time of presentation in order to refill Fentanyl. If Fentanyl, Versed, or Ketamine were wasted, the Pharmacy Exchange Form must be signed by a second paramedic that witnessed this waste. A copy of the Pharmacy Exchange Form should be saved and stored in a locked box at each station. Any requests for medication exchange which occur without a patient encounter and residual sample will have to be forwarded to the medical director for approval.
Restocking of Outdated medications:
All medications that are outdated may be exchanged through the hospital pharmacies with whom the agencies contract for this service. The appropriate form will be filled out indicating the amount and types of medications needed for exchange. Any controlled substances will need to be surrendered to the pharmacists and exchanged on a one to one basis only, unless previously approved by the medical director or his designee. This form should be faxed to the pharmacy 8 hours in advance of picking the medications up. The medications exchanged will be charged to the services as per existing agreements. When exchanging medications that are not controlled substances the rescue agency may bring any outdated medications to the pharmacy for appropriate disposal by the pharmacies current operating procedures without cost to the agency.
*Note: The hospitals currently have very limited use for the medications exchanged and are typically not utilizing them if returned with a short shelf life left (e.g. 30 days). As such the agencies should wait until the medications are outdated before exchanging them.
Stocking of a New Rescue Squad:
The agency should fax the medication request form, along with a prescription from the medical director for any controlled substances requested 24 hours in advance of picking the medications up. The medical director will submit a signed list of approved medications to the pharmacies on an annual basis or less if any changes are made. Only medications on this list will be dispensed unless accompanied by a signed prescription by the medical director.
