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3.04.05 Drug Boxes

3.04.05 Drug Boxes (Revised 10/2022)


EMS Drug boxes have been stocked with all necessary emergency medications. All medications have been reviewed and approved by the Amerimed Medical Director. Should there be medications supplied to you that you are not thoroughly familiar with, you should research the drug and know the dosage, effect, indications, contra-indications, side effects and antidote before using the drug. Alternately you may inform your management team and they will provide the proper education.The medication manual also provides information as to how the medication is supplied, however; it is the responsibility of the administering paramedic to ensure the correct administration as medication supply and concentration is subject to change without notice.

It is critical that all multi-dose medications are dated as they are opened. Each time a medic uses one of these, the date must be written on the label of the medication. The medication may be used for the remainder of the shift or until the box can be returned for restocking.


Any Time a Drug Box Seal is Broken:

Field crews should notify his/her immediate supervisor or a member of management to arrange the drug box to be exchanged (accidental breaks included). All drug boxes where the seal is broken will be returned to HQ for restocking or exchange. Amerimed has spare boxes in the ALS room. If any item, drug or supply, is missing from drug box, a Patient Care Report (“PCR”) form and a Drug Box Usage Form must be included inside the box. The PCR should have date and drug box number documented in the proper locations. Once appropriate paperwork is inside the drug box, the box should be resealed with the replacement seal that is located inside. See 3.4.3 Documentation, Section B, #13

A list of current medications carried in the Amerimed drug box and the expiration dates for each is attached to the top of the drug box. See 3.4.1 Daily Operations Routine, Section C


Drug Waste:

It is required to fill out the Drug Waste section each and every time the narcotics box is opened. This must be done even if you have not administered any drugs.

If a portion or an entire dose of any narcotic is used on a patient, you must fill out the form and have an RN or Physician sign with you showing that drug has in fact been wasted or administered to patient. The witness may not be your partner.


Narcotic Usage:

Narcotics will be stored in a double locked safe or storage device. The narcotics must have a breakaway tag with identification number that will be logged into the narcotics check in/out log. All narcotics should not be expired and should be checked for breakage and expire date at the beginning of the ALS shift. If you find that the narcotic is expired or has been broken, immediately notify the management team for immediate replacement.

If a paramedic uses a narcotic for patient care, they must document, in the ePCR, the type/name of the drug given, amount, time, route and any untoward effects. They must turn in the used vial to the Shift Commander at the end of their shift. Follow the above guidance for wasting unused drug.