Drug Bag/Pharmacy Changes

Starting this Tuesday, September 3rd, at 00:00, we will be implementing changes to the drug bags as well as the exchange process.

This is a long post and I apologize, but you need to take time to read this and familiarize yourself with this process as there are SIGNIFICANT changes. Because pharmacy will no longer be keeping track of our medications like they used to, it will require changes to the way we track and monitor.

After Tuesday, ALL the old forms will need to be removed and replaced with the new ones (located on the forms section of this site). This includes the Drug Bag Manifest that is usually in the front pocket.

Drug Bags

1. These will no longer be traded in to pharmacy. Your bags now belong to your agency and you can use a different bag if you want. You can also reorganize or do whatever you like with the drugs for organization. There will need to be a bag #, but besides that, I don’t care what you do for organization.

2. The ALS and BLS boxes will no longer be separated. I don’t care how you arrange them or if you keep them separate/together, just so long as the BLS crews have access to what they need. The same form will be used for ALS or BLS crews when completing the daily sheet.

Daily Sheet

1. The daily sheet will be changed and must begin being used on the 3rd.

2. This will be completed daily and sent to me at the end of your shift EVERY TIME. I will be monitoring this very strictly along with your managers to ensure we are completing this correctly. You will also need to keep this in a binder on your unit in case you are inspected by DHS. You will need to prove a chain of custody and each sheet will show that days ownership for the bag.

3. The “Old Seal #” is the tag you break off when inspecting your bag, the “New Seal #” is the LAST ONE you apply during your shift. This line item will be completed at the end of your shift when doing the handoff with the person you are transferring custody to. I no longer care how many times you break open your box during your shift or how many different tag numbers are applied. Only the first one and the last one will need to be recorded. The others you use during your shift may be documented on the notes section of the form if you want to keep track for yourself.

4. ALS will complete a face to face handoff. If ALS is turning it over to BLS, the process will still be the same. If BLS is handing over to BLS, then simply writing the same tag number at the beginning and end of your shift is appropriate. Please just check off the items that you will utilize on your shift.

5. For units that are not always staffed (i.e. on-call units), this form will be completed when the crew first comes on duty. 2 providers will need to be present to witness the checkoff.

6. For volunteer units, a checkoff sheet will only be completed when the drug bag is opened/used.

7. If you use a med during the shift, place a check mark next to the med used under the far right column. If any discrepancies are found at any time or there is a broken vial, etc., DOCUMENT this on the notes section and contact me during business hours. If the discrepancy involves a controlled substance, contact me 24/7.

8. There are some changes to the drugs and the minimum supply. Please note this and pay attention to the supply levels. If you have more controlled substances than is on the sheet, this must be reported to me immediately. If you have extras of anything else, you may keep them in your bag. You don’t HAVE to restock them until you get down to the minimum supply par levels on the sheet. If your agency determines they want to keep a higher par level of a non-controlled substance (or an additional non-controlled med), that will be communicated to you from your manager and you will need to maintain that particular par level for that drug instead of the minimum that is listed on the sheet.

Monthly Expirations Log

1. The 1st shift of each month the crew will complete the Expirations Log. If expirations need exchanged, complete at this time.

2. On-call units and volunteer units will be checked off within the 1st week of the month and meds exchanged if needed at that time.

3. Copies will be sent to me upon completion and also kept in your log.

Exchange process

1. If you use a drug on a patient, complete the form in the ED. Give the completed form to the charge nurse (if they are too busy, you can take it to pharmacy from 07:00-19:00). The physician will sign this if it is a controlled substance and this will take the place of your prescription you used to get from them. Be patient with the ED staff, this is a new process for them as well so there may be some learning curves. If you or the charge nurse have questions, please call me 24/7 so we can make sure you get back in service.

2. Supplies used (syringes, needles, flushes) will not be replaced by pharmacy or the ED. You will be required to supply these items in your box from your agency.

3. If you have medications that are going to expire within the month, take it to the PHARMACY ONLY for exchange. The ED will not be able to help with this. There will be a form they give you to fill out for exchange.

If you have any questions regarding this post or the new changes, PLEASE contact me sooner rather than later to work out any details.

Thank you for your patience and understanding while we develop changes that will hopefully improve our efficiency and make this a great high performance EMS system!


Mt. Graham Prehospital
CE Night this Wednesday

Don't forget about August's CE night at Pima Fire Department this Wednesday, August 7th at 18:00. Dr. David Bryce will be talking to us about the changes to spinal immobilization. Please add this to your calendar!

Mt. Graham Prehospital