In consultation with the Pharmacy Committee and upon approval of Dr. Lawson, additional changes will be made to the Red medication box inventory.

This is a TEMPORARY MODIFICATION to the medication boxes. Due to additional nationwide manufacturer shortages, there will be the following TEMPORARY MODIFICATIONS to the RED medication boxes in the PEMS region, beginning June 24, 2010:

• Furosemide (Lasix) - The medication box packaging will be reduced from two (2) 100 mg pre-filled syringes to one (1) 100 mg pre-filled syringe.

• Naloxone (Narcan) - The medication box packaging will be reduced from four (4) 2 mg pre-filled syringes to two (2) 2 mg pre-filled syringes.

PROBLEM:
Furosemide and Narcan are in short supply from distributors and vendors. All pharmacies in our region are experiencing shortages on a variety of pre-filled medications on their pharmacy shelves and experiencing issues in obtaining additional medication in a timely manner from their suppliers. It is possible that we will see shortages for several weeks. This issue is effecting several of our neighboring EMS Councils as well.

OUTSIDE LABEL:
A label will be affixed to medication boxes above the expiration date sticker stating: “LASIX AND NARCAN PREFILLS REDUCED” with handwritten date on the sticker that the pre-fills were removed.

There are no changes to current ALS protocols regarding administration of Furosemide or Narcan. This medication box change is a special, short term reduction. All regionally authorized ALS providers should be familiar with proper medication preparation methods (drawing up medications and concentrations). However, ALS providers, Agency heads, and Training Officers should review the changes to the medication box on a frequent basis. The PEMS website will be updated with the most recent modifications as they occur.

As a reminder, with any of the recent medication box inventory modifications, if you experience a situation where a change has resulted in an adverse effect on a patient, please report these incidents to your agency Operational Medical Director and the PEMS office (Attn: Greg Hunter).

Should you have any questions regarding this change or need additional assistance or clarification, feel free to contact Jeff Meyer, This e-mail address is being protected from spambots. You need JavaScript enabled to view it , Jerry Andrews, This e-mail address is being protected from spambots. You need JavaScript enabled to view it , or myself, This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Red Box Memo (06-28-10)