Controlled Substances Regulations Quiz
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Questions and Answers

What is required for any administration of controlled substances by EMS crews?

  • The drugs should be disposed of immediately.
  • An EMS report must be completed by the end of the shift. (correct)
  • Documentation should be completed within 24 hours.
  • Nothing needs to be recorded if the substance is not used.

    • Who is responsible for maintaining the electronic listing of drugs in each drug box or container?

  • The Chief of Fire and Rescue
  • The regional inventory representative (correct)
  • The EMS Division Manager
  • The individual EMS providers

    • Who is responsible for the security of the master-controlled substance stock?

  • The Hospital Administration
  • The Chief Pharmacist
  • The Controlled Substances Coordinator or designated representative (correct)
  • The Pharmacy Technician

    • Where are all EMS run reports ultimately stored?

    <p>At the office of the Chief of Fire and Rescue</p> Signup and view all the answers

    How will the Electronic Reporting System contribute to the regional inventory management?

    <p>By being accessible to members of the inventory committee.</p> Signup and view all the answers

    Which of the following is NOT considered a Schedule II Controlled Substance?

    <p>Diazepam</p> Signup and view all the answers

    What is the required procedure for the transfer of drugs?

    <p>A two-person operation must inspect the medications</p> Signup and view all the answers

    What procedure should be followed for expired drugs within the region?

    <p>They must be documented and disposed of properly.</p> Signup and view all the answers

    How should controlled substances be acquired?

    <p>Through authorized providers like Consultant Pharmacist or accepted vendors</p> Signup and view all the answers

    How often will an annual inventory of controlled substances be conducted?

    <p>Once a year within 4 days before or after May 1st</p> Signup and view all the answers

    How should the receipt of drugs be documented?

    <p>Using an inventory log maintained by the pharmacist</p> Signup and view all the answers

    What information should the EMS report account for regarding medications?

    <p>Total amount administered and wasted from the vial</p> Signup and view all the answers

    What happens if a controlled substance is used during an EMS run?

    <p>An EMS report must be submitted with the usage documented.</p> Signup and view all the answers

    What must be done if discrepancies are noted during the drug transfer?

    <p>A new transfer should be initiated only after resolving the discrepancies</p> Signup and view all the answers

    Which is an essential part of drug storage in jump kits?

    <p>Designating items and defining par levels of drugs</p> Signup and view all the answers

    Which of the following is a responsibility of the Controlled Substances Coordinator?

    <p>Replace all controlled substances and manage related documentation</p> Signup and view all the answers

    How long must records pertinent to the EMS clinic license be retained?

    <p>3 years</p> Signup and view all the answers

    Who is responsible for the administration of the Department?

    <p>Chief of Fire and Rescue</p> Signup and view all the answers

    Which of the following best describes the role of the Consultant Pharmacist?

    <p>Chief executive for drug acquisition and accountability</p> Signup and view all the answers

    What is the primary responsibility of the Medical Director?

    <p>Issue protocol and guidelines for Emergency Medical Technicians</p> Signup and view all the answers

    Who is defined as the Controlled Substance Coordinator (CSC)?

    <p>An employee with custody of the controlled substance master stock</p> Signup and view all the answers

    Which term refers to a licensed Emergency Medical Technician who may administer dangerous drugs?

    <p>Licensed Provider</p> Signup and view all the answers

    What role does a Supervisor play in the Department?

    <p>Manages field personnel and interprets documentation</p> Signup and view all the answers

    What is the definition of an EMT-Paramedic?

    <p>A licensed technician permitted to administer drugs</p> Signup and view all the answers

    What should be done first if a discrepancy is noted?

    <p>Contact the supervisor and CSC.</p> Signup and view all the answers

    Who is authorized to possess controlled substances?

    <p>Only licensed EMT-Paramedics and supervisors.</p> Signup and view all the answers

    What is required when conducting an inventory check of controlled substances?

    <p>Two members must sign for accuracy.</p> Signup and view all the answers

    What is the protocol for when an EMT-Paramedic or Lieutenant is not available?

    <p>A supervisor must be contacted to take possession.</p> Signup and view all the answers

    What is considered a permissible method for storing controlled substances?

    <p>Inside a container on the assigned vehicle.</p> Signup and view all the answers

    What security measures must be in place for controlled substances?

    <p>Double lock access and key codes must be maintained by the responsible employee.</p> Signup and view all the answers

    What documentation is necessary when an employee takes possession of controlled substances?

    <p>The employee must sign the Electronic Controlled Substances Log.</p> Signup and view all the answers

    How often should a daily inventory of controlled substances be taken?

    <p>At any time there is a change of possession.</p> Signup and view all the answers

    What is the dosage of Dextrose D10W for pediatric patients in hypoglycemic situations?

    <p>5 ml/kg IV/IO up to 25g/250ml</p> Signup and view all the answers

    In which situations is Diazepam indicated for use?

    <p>Seizures and adult acute coronary syndrome</p> Signup and view all the answers

    What is the maximum dosage of Fentanyl that can be administered to an adult patient?

    <p>3.0 mcg/kg</p> Signup and view all the answers

    For an adult experiencing anaphylaxis, what is the recommended dose of Epinephrine?

    <p>0.3 mg 1:1,000 IM</p> Signup and view all the answers

    What is the dosage for Hydroxocobalamin in cases of cyanide poisoning for adults?

    <p>5 g IV/IO over 15 minutes</p> Signup and view all the answers

    What is the pediatric dosage for Diazepam in a situation involving seizures?

    <p>0.5 mg/kg IV/IO, repeat once in 5 minutes</p> Signup and view all the answers

    What is the maximum dosage of Diphenhydramine for treating anaphylaxis?

    <p>50 mg</p> Signup and view all the answers

    What is the correct method of administration for Epinephrine during a cardiac arrest?

    <p>1 mg 1:10,000 via ET</p> Signup and view all the answers

    Study Notes

    Controlled Substances

    • Controlled substances require high security and control procedures.
    • Examples include: Morphine Sulfate, Fentanyl Citrate, Diazepam, and Midazolam.
    • The Pharmacist may designate any drug with potential or history of abuse to be handled according to these procedures.

    Acquisition

    • The CSC or their designee is responsible for acquiring controlled substances.
    • Replacement stock is based on documentation of initial stock values and no conflicts in reporting.
    • Substances will be obtained from the Consultant Pharmacist or an accepted vendor.

    Transfer

    • Transfer of drugs is a two-person operation, involving the employee with current possession (off-going) and the employee taking custody (on-coming).
    • Medications are inspected, volume is examined, and expiration dates are checked.
    • Both individuals sign the Electronic Controlled Substances Log to account for the exchange of responsibility.
    • Discrepancies are reported to the supervisor and CSC.
    • An Electronic Controlled Substance Action Form must be completed.

    Inventory

    • Inventory is the responsibility of employees authorized to possess controlled substances.
    • Two members must sign for accuracy during inventory assessment or transfer.
    • Daily inventory must be performed when a change of possession occurs.
    • Inventory values are recorded on the Electronic Controlled Substances Log.

    Possession

    • Possession of controlled substances is authorized only for licensed EMT-Paramedics and supervisors (Lieutenant, Captain, Commander, or Chief).
    • All employees taking possession must inspect the stock and sign the Electronic Controlled Substances Log.
    • Controlled substances are to remain on the vehicle assigned, regardless of the employee in possession.
    • Double lock access, with the key codes under the control of the employee who signed for the substances, provides security.

    Storage

    • Controlled substances can be stored in three ways:
      • Carried by a licensed EMT-Paramedic on their person during patient care or access.
      • Stored within a container on the assigned vehicle, complying with standards set in Section VII.
      • Stored in the temperature-monitored facility located at the EMS Office at the Atrium, with the same minimum standards as Section VII.
    • Records are maintained centrally at the EMS Office, with the controlled substance master stock, and logged at the station where the substance is stored or administered.

    Expired Drug Log Forms

    • Electronic Expired Drug Log Forms are maintained at the Regional Inventory Station to track expired drugs.
    • Expired drugs are collected and returned to the EMS Division for disposal.

    Electronic EMS Run Reports

    • Reports are submitted for all use and waste of controlled substances.
    • Any drug use is documented, including administration or waste.
    • The report must account for all medication in the vial.
    • The report must be completed by the end of the shift for controlled substance administration, enabling restocking by the EMS Division.
    • This includes late calls.
    • Eventually, all EMS run reports are stored at the office of the Chief of Fire and Rescue, with a copy filed with the CSC if a controlled substance use occurs.

    Inventory Records

    • The Regional Inventory Station (RIS) maintains a record of all drugs within their region.
    • Records are accessible by the inventory committee members and are maintained in the Electronic Reporting System.

    Per Truck/Drug Box

    • An Electronic listing is maintained for each drug box/kit/container, indicating its contents and expiration dates.
    • This log reflects the on-hand stock available for immediate use.
    • It's the responsibility of the regional inventory representative.

    Per Drug

    • An Electronic listing is maintained for each drug, indicating the quantity in the region and its location, including expired and unexpired drugs.
    • This log reflects the total available quantity and serves as a guide for ordering.
    • It's the responsibility of the regional inventory station.

    Annual Inventory

    • Annual inventory of controlled substances is completed by the EMS division within 4 days before or after May 1st of each year.

    Record Retention

    • All records pertinent to the EMS clinic license must be retained for a minimum of 3 years.

    Definitions

    • Terms are intended to be gender neutral.
    • "He or his" includes "she or her."
    • Chief of Fire and Rescue: The department head appointed by the County Manager or the Board of County Commissioners, responsible for the administration of the Department.
    • Consultant Pharmacist: Licensed Pharmacist under contract to the Department, responsible for drug acquisition, storage, accountability, and disposal.
    • Medical Director: The licensed Medical Control Emergency Physician (MCEP) responsible for issuing protocols, guidelines, and standing orders for Emergency Medical Technicians.
    • Controlled Substance Coordinator (CSC): Department employee with custody of the master controlled substance stock, responsible for replacing all schedule 2, 2N, 3, 3N, 4, and 5 drugs, and storing associated documentation.
    • Supervisor: Any line supervisor (Lieutenant, Captain, or Commander) responsible for field personnel management.
    • Licensed Provider: Authorized Emergency Medical Technician who may administer dangerous drugs or controlled substances consistent with their licensure level.
    • EMT-Paramedic: Licensed technician authorized to administer drugs consistent with the Medical Director's standing orders, protocols, and guidelines.

    Medications and Dosages

    • Dextrose: 50%, 25%, 10%, 5% for hypoglycemia, medical diabetic emergencies, seizures, Neonatal resuscitation pre-eclampsia, eclampsia.
      • Adults: Wide open IV/IO
      • Pediatrics: 5 ml/kg IV/IO up to 25 g/250 ml
    • Diazepam: [Valium:] Airway management, Adult Acute Coronary Syndrome, Adult/Pediatric Symptomatic Bradycardia, Adult/Pediatric Narrow Complex Regular Tachycardia, Adult/Pediatric Narrow Complex Irregular Tachycardia, Adult/Pediatric Wide Complex Irregular Tachycardia, Adult/Pediatric Post-Resuscitation Cardiac Arrest Care, Adult Drug Overdose, Bites/Envenomation's, Seizures.
      • Adult: 2.5mg IV/IO, repeat once in 5 minutes.
      • Pediatric: 0.05 mg/kg IV/IO, repeat once in 5 minutes.
      • Agitated and delirious patient, alcohol/benzodiazepine withdrawal. Based off BSI index and CIWA score.
      • Adult Drug Overdose, seizures, Status Epilepticus, Pre-Eclampsia/Eclampsia.
        • Adult: 10mg IV/IO, repeat 2.5mg q5 minutes max 20mg.
      • Crush injury: Contact MCEPT
    • Diphenhydramine: 0.5-1 mg/kg up to 50 mg for anaphylaxis
    • Droperidol: Chemical Sedation for the agitated and Delirious Patient:
      • Adult: 2.5mg-10mg IM or IV based on the BSI score
      • Pediatric: Not approved
    • D5w: 50 ml, for use with amiodarone
    • Epinephrine:
      • Cardiac arrest: 1 mg 1:10,000 IV/IO or 2 mg 1:1,000 ET (pediatric: 0.01 mg/kg 1:10,000 IV/IO or 0.1 mg/kg 1:1,000 ET)
      • Severe croup/epiglottitis and anaphylaxis with airway swelling: 0.05 mg/kg (max 3 mg) 1:1,000 diluted to 3 ml in NS nebulized
      • Anaphylaxis: 0.3 mg 1:1,000 IM (pediatric 0.01 mg/kg)
      • Reactive airway disease: 0.3 mg 1:1,000 SQ/IM (pediatric 0.01 mg/kg)
      • Bradycardia, Cardiogenic Shock, Anaphylaxis, Drug Overdose, Snakebite & Sepsis: Adult 2-10 mcg/min
    • Fentanyl: Patients presenting with pain or discomfort
      • Adult: 1.0-3.0 mcg/kg to a maximum of 3.0mcg/kg.
      • MCEP contact required if patient requires more than 3mcg/kg
      • Administer in 0.5-1.0 mcg/kg increments, may repeat every 5 minutes up to a maximum dose.
      • Pediatric: Children 2 years of age and older may receive Fentanyl. The dosing is the same as adults.
    • Glucagon: Diabetic Emergencies
      • Adult: 0.5-1mg IM, repeat in 10-20 minutes.
      • Pediatric: 0.1 mg/kg IM, repeat in 10-20 minutes, max 1 mg.
    • Hydroxocobalamin (CyanoKit): Cyanide Poisoning
      • Adult: 5g IV/IO over 15 minutes
      • Pediatric: 70mg/kg IV/IO over 15 minutes
    • Ibuprofen: (Advil, Motrin)
      • Adult pain, Fever: 400-600 mg PO
      • Pediatric Pain/Fever: 10mg/kg PO > 6mos old.

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    Related Documents

    Bernalillo County Fire & Rescue Drug Policy PDF

    Description

    Test your knowledge on the regulations and procedures surrounding controlled substances. This quiz covers acquisition, storage, and transfer processes, highlighting security measures and documentation requirements. Essential for pharmacy professionals managing controlled substances.

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