EMS CONTROLLED SUBSTANCE (CS) Program

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Questions and Answers

What must be documented in the ePCR when sequential doses are given from a single syringe?

Only the total dose administered

Separate entries for each dose (correct)

The time of administration only

The name of the patient receiving the dose

What should happen to syringes containing controlled substances during preparation?

They can be stored away from view

They must be placed in a locked cabinet

They can be passed to another personnel for administration

They must remain under direct control of the preparer (correct)

What is required for documentation of controlled substances when they are wasted?

Mentioned verbally to the supervisor

Noted in the ePCR and at the hospital (correct)

Documented only in the ePCR

Not necessary to document

Under what circumstances may EMS vehicles store controlled substances?

When secured at a registered location or in transit in emergencies Signup and view all the answers

How many ALS personnel must sign each PCR for controlled substances?

Two Signup and view all the answers

How long should records be kept according to the regulations?

Two years Signup and view all the answers

What is essential for the format of records kept by EMS agencies?

Sequential and easily reviewable Signup and view all the answers

What must each EMS agency maintain to evidence the chain of custody?

Controlled Substance Log Signup and view all the answers

Where should records of controlled substances be stored?

At each registered and designated location Signup and view all the answers

Which requirement is NOT mentioned for the records of controlled substances?

Digital storage only Signup and view all the answers

What is a standing order in the context of EMS agencies administering controlled substances?

A written medical protocol outlining criteria for administering drugs. Signup and view all the answers

Which of the following is true about the medical director in relation to EMS agencies?

Must be registered with the DEA to administer controlled substances. Signup and view all the answers

What must an EMS agency have in order to administer controlled substances outside of the medical director's presence?

Authorization from state law. Signup and view all the answers

What does the term 'verbal order' mean in EMS contexts?

An oral directive given to administer controlled substances. Signup and view all the answers

Which schedule of controlled substances can EMS agencies administer under standing orders?

Controlled substances from schedules II to V. Signup and view all the answers

In relation to drug oversight, EMS personnel must be competent in which of the following?

Regulatory requirements and established procedures. Signup and view all the answers

Which of the following is NOT a requirement for EMS agencies administering controlled substances?

Physical presence of a medical professional. Signup and view all the answers

What specific type of order provides real-time instructions to EMS professionals?

Verbal orders during emergencies. Signup and view all the answers

What behavior can lead to disciplinary action by the EMS Agency?

Falsification of EMS records Signup and view all the answers

Which of the following is required before restocking controlled substances from another ALS EMS vehicle?

Verification by two ALS personnel Signup and view all the answers

What is a must for the exchanged controlled substances during restocking?

Exchanged controlled substances must meet packaging and dosing specifications. Signup and view all the answers

What action should ALS clinicians take if they cannot complete an equal exchange on scene?

Bring the original open packaging to the receiving hospital. Signup and view all the answers

Intra-agency exchange of controlled substances between two responding vehicles does not require which of the following?

Controlled Substance Restock and Exchange Form Signup and view all the answers

Which behavior is explicitly prohibited during an EMS duty cycle?

Two or more instances of unexplained discrepancies Signup and view all the answers

Which statement about restocking controlled substances is false?

Restocking can be done without considering expiration dates. Signup and view all the answers

What is NOT required when an ALS clinician gives a controlled substance from their vehicle's inventory but does not transport the patient?

Verification of contents by one ALS personnel Signup and view all the answers

What is required for EMS professionals who administer controlled substances?

Compliance with the agency's registration act Signup and view all the answers

What is one of the recordkeeping requirements for EMS agencies regarding controlled substances?

Keep a record of the standing orders issued Signup and view all the answers

Which of the following must EMS personnel do when preparing controlled substances?

Label syringes with drug name, dose, and their initials Signup and view all the answers

What must be complied with regarding the storage of controlled substances?

The physical security requirements established by the Attorney General Signup and view all the answers

What is the protocol for drug administration by ALS EMS personnel?

Administer approved controlled substances if compliant with SOPs Signup and view all the answers

What happens to controlled substances issued to EMS vehicles?

They are provided based on inventory levels specified Signup and view all the answers

Who can EMS personnel administer controlled substances without?

The physical presence of a medical director Signup and view all the answers

Which of the following is NOT a recordkeeping requirement for EMS regarding controlled substances?

Documenting unauthorized use of drugs Signup and view all the answers

Study Notes

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.

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Description

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.