EMS CONTROLLED SUBSTANCE (CS) Program

Use of Standing Orders in EMS

• EMS agencies can administer controlled substances (CS) from schedules II to V without the medical director on-site provided they comply with the PPAEMA.
• Two primary conditions must be met: authorization by state law and possession of a standing or verbal order from a medical director or authorized professional.

Definitions Relevant to Standing Orders

• Medical Director: A DEA-registered physician overseeing the administration of controlled substances in EMS.
• Standing Order: A pre-established written protocol specifying medical criteria for CS administration to patients.
• Verbal Order: An oral directive allowing EMS professionals to administer CS through communication methods like radio or phone while not in the presence of a medical director.

Policy Guidelines

• All drugs to EMS must be handled according to legal and regulatory standards including procurement, storage, inventory, clinical administration, documentation, and restocking.
• EMS personnel must be licensed and educated in handling CS in a compliant manner.
• Detailed recordkeeping for CS administration is essential, ensuring compliance with registration requirements and security measures stipulated by the Attorney General.

Administrative Procedures

• Procurement: CS is dispensed to newly approved ALS vehicles based on the Drug and Supply List.
• Drug Administration: EMS staff can administer authorized CS during patient care without direct supervision, ensuring labeling and documentation protocols are followed for accountability.
• Records related to CS must be maintained for two years and be readily available for DEA inspection.

Storage and Security

• CS can be stored in registered DEA locations, unregistered sites, and EMS vehicles adhering to security regulations.
• Records must include all transactions involving CS, outlining deliveries, administration, and disposal, kept at the relevant locations.

Chain of Custody and Documentation

• An unbroken chain of custody must be maintained with a completed Controlled Substance Log for each EMS vehicle carrying CS.
• Any breach in this chain of custody or falsification of records may result in disciplinary actions against EMS personnel.

Peer to Peer Controlled Substance Exchanges

• ALS clinicians can restock CS on-scene with other ALS vehicles, ensuring correct medication specifications are met.
• Verification for restocking must be conducted by two ALS personnel ensuring accuracy in medication, concentration, amount, and expiration date.
• If a matching exchange isn't possible, original opened items must be brought to the receiving hospital for proper disposal.

Intra-Agency CS Exchanges

• CS exchanges between responding vehicles from the same agency can proceed without documentation if conducted directly on-site.

This quiz covers the essential regulations and requirements for emergency medical services professionals who administer controlled substances. Focus is on the agency's registration act, recordkeeping, and physical security standards. Test your knowledge on compliance and operational protocols.