Narcotics: Certified ALS personnel (paramedics and RNs)
functioning under approved medical control jurisdiction may be issued approved
controlled substances for pre-hospital use upon the discretion of the off-line
medical director. For ALS services that are not hospital-based, the Drug
Enforcement Administration (DEA) requires the off-line medical director to
secure a separate CONTROLLED SUBSTANCES REGISTRATION CERTIFICATE to store,
issue and prescribe controlled substances to ALS personnel. This CERTIFICATE
should list the medical director as a "practitioner" at the physical address of
the ambulance service where the drugs are stored. The off-line medical director
will determine who may issue and administer the controlled substances and who
will have access to storage of these narcotics. #24068
1. Controlled substances must be secured in
accordance with applicable state and federal regulations. The paramedic's
narcotics should be secured in a designated location when he is not on duty and
actively functioning under the service's medical control. When on duty, each
paramedic should keep his controlled drugs in his immediate possession or
securely locked in the vehicle at all times.
2. Whenever an order is received from medical
control for administration of a narcotic, the paramedic must keep track of the
vial/ampule being utilized. If the full amount of the narcotic was not
administered, the remainder must be wasted in the presence of a witness and the
witness must sign the patient report documenting the same. The witness should
preferably be a licensed health care provider who is authorized to administer
narcotics themselves.
3. Narcotics
should be replaced and logged within 24 hours of administration. Narcotics logs
should be maintained by the ALS service. Paramedics should individually
document the following minimum information in the narcotics log: Date of
administration; Time of administration; Amount administered; Amount wasted;
Witness to wasted amount; Patient's name; Call number; Ordering
physician
4. Any paramedic/RN that
is separated from the ALS service's medical control authority shall surrender
his narcotics upon demand or be subject to prosecution under applicable
statutes
