Med KitThe regional Medication Kit of the Peninsulas EMS Council, Inc. is a critical component of the EMS system for the treatment of sick or injured persons. The basis for restocking these medication boxes is contained in this   PEMS Regional Medication Box Plan signed by participating acute care hospitals and out-of-hospital agencies.

The medications stocked within the Medication Kits are selected and approved for use by the Protocols, Policies & Procedures (PPP) Committee in coordination with the Pharmacy Committee.  Each of the hospitals inside the PEMS region (and several outside the region, but with our catchment area) has agreed to replace medications used in the prehospital setting on a one-for-one basis.  This exchange takes place at the hospital pharmacy or emergency department.

PEMS Medication Kits are accounted for using a real-time inventory control system operated by PEMS and the area pharmacies to ensure that security of the medications is maintained and all users in the system have sufficient Medication Kits to operate efficiently.

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~ PEMS RSI Medication Kit ~

PEMS RSI medication box pic exterior May 17The PEMS Rapid Sequence Intubation (RSI) Medication Kit is a separate kit used for difficult airway management patients.  It is only used by specifically selected and trained Paramedics with approval from their OMDs.  Only a few agencies are performing RSI at this time due to the extensive training, competence and quality assurance requirements.

 

 

 

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~ Important Medication Kit Forms ~

  • Medication Kit Schematic - This document graphically displays the normal layout of the PEMS Medication Kit.  Please note that medication availability and packaging can cause deviations from this layout.
  • Medication Use/Wastage Form  - This form is for documenting the use and wastage of controlled medications contained in the PEMS Medication Kits.
  • Medication Kit Inventory  - This form is used by our partner pharmacists and pharmacy technicians to ensure that each PEMS Medication Kit is properly stocked with medications having reasonable intervals before expiration.
  • Medication Kit Exchange Form  - This form is used to document the exchange of PEMS Medication Kits between users and hospital personnel.
  • RSI Medication Kit Inventory - This form is used by our partner pharmacists and pharmacy technicians to ensure that each PEMS RSI Medication Kit is properly stocked with medications having reasonable intervals before expiration.
  • Medication Kit Transfer Form - This form is used to document the transfer of PEMS Medication Kits between different agencies.
  • OEMS EMS Agency Drug Diversion Report Form  - This form is used to report diversion of controlled medications.

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~ Medication Kit Incident Report ~

The Peninsulas EMS Council, our Pharmacy Committee, and our PPP Committee work hard to make the Medication Kit System as secure and easy to use as possible.  However, circumstances do occasionally result in problems with Medication Kits. These problems are reported using the PEMS Medication Kit Incident Report. This report may be filed by anyone finding a problem with a PEMS Medication Kit or the system that supports it.  PEMS will follow up each incident to ensure that problems are resolved.

  Click here to submit a Medication Kit Incident Report .

Please fax the completed report to:  804-302-6073. This a secure electronic fax that meets all HIPAA/PHI security requirements.

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~ PEMS Medication Kit Exchanges at Facilities Outside PEMS Region ~

PEMS has been fortunate to have entered into a PEMS Regional Ambulance Restocking Agreement with several facilities outside the PEMS region recently. These agreements were made to facilitate speedy return to service for agencies transporting to these facilities.  They are not designed to provide for the routine exchange of PEMS Medication Kits that are expired or about to expire. Please do not attempt to exchange the PEMS Region Medication Kits for expired or about to expire boxes at any hospital outside the PEMS regionThese boxes will need to be exchanged at our PEMS region hospitals including: Riverside Regional Medical Center, Sentara Careplex Hospital, Bon Secours Mary Immaculate Hospital, Riverside Walter Reed Hospital, Riverside Doctors’ Hospital, Sentara Williamsburg Regional Medical Center, Bon Secours Rappahannock General Hospital, or Riverside Tappahannock Hospital.

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~ Medication Kit Shortages & Changes ~

  • Dextrose 50% 25gm/50ml preload - Pharmacies in the PEMS region are experiencing difficulty getting Dextrose 50% 25gm/50ml preload.  As the D50 currently in the PEMS Medication Kits are used (beginning May 2017) there may be no replacement available. They will reduce the number from 2 preloaded syringes to 1, as needed to help during this shortage. Affected Medication Kits will be identified by a note placed in the exterior pocket.  (Posted 05-16-17).

  • Calcium Chloride - Pharmacies in the PEMS region are experiencing difficulty getting Calcium Chloride in the 1gm/10mL preload packaging.  As the Calcium Chloride currently in the PEMS Medication Kits expires (beginning April 2017) there may be no replacement available. Affected Medication Kits will be identified by a note placed in the exterior pocket.  (Posted 03-29-17).

  • Teleflex Intranasal Mucosal Atomization Devices (MADs) - The Pharmacy Committee, in

    coordination with PEMS, has started inserting the Intranasal Mucosal Atomization Device (MAD) in the Medication Kits and providers may resume use immediately as they become available in the Medication Kits. 

    If your agency stocks its own supply of the MAD, ensure that the lot numbers for the devices are not affected by the November 2016 recall.  Click here to see the affected lot numbers.

    Please note that it will take a while before all Medication Kits have been exchanged and supplied with the appropriate devices.  Lack of a MAD during this period does not constitute the need to submit a Drug Box Incident Report.
  • Dopamine - Pharmacies in the PEMS region are experiencing difficulty getting Dopamine in the 400mg/10ml packaging. As the Dopamine currently in the PEMS Medication Boxes expires (beginning July 2016), it may be replaced with 400mg/250ml IV piggyback packaging as seen here. This packaging may be located in the main compartment under the clear plastic divider or it may be placed in the clear sealed bottom compartment of the red Thomas Pack. Affected Medication Boxes will be identified by a note placed in the exterior pocket.  (Posted 06-22-16)
  • Epinephrine 1mg/ml 1:10,000  - Regional hospitals are experiencing a shortage of prefilled epinephrine syringes.  Because of this, the pharmacies may reduce the number of prefilled syringes from 8 to 0 inside Medication Kits being restocked. A card will be placed in the outer pouch of a Medication Kit if it is affected.  Please note that there is still a 30cc 1:1000 multi-dose vial of epinephrine in the Medication Kit.  You can prepare 1:10,000 epinephrine by expending 1 cc from a prefilled 10 cc saline syringe and drawing 1 cc of 1:1000 epinephrine from the multi-dose vial. As always, have your partner verify your medication prior to administering.  (Posted 06-05-17)

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Alert - FDA Approves Extended Use Dates for Some PEMS Medications


Due to the ongoing critical shortages of injectable drugs used in critical care, the FDA has approved extending the expiration dates of certain medications noted in the link below.  These medications include some prefilled syringes containing atropine, D50, sodium bicarbonate and epinephrine.  This list is subject to change and the link should be reviewed occasionally.  PEMS will provide notification when we become aware of any changes.  To help ensure patient safety, these products must continue to be stored as per labeled conditions.  

Please click on the link to access the list of extended medications:  https://www.fda.gov/Drugs/DrugSafety/DrugShortages/ucm563360.htm

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