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PA Bulletin, Doc. No. 02-1002

NOTICES

Approved Drugs for ALS Ambulance Services

[32 Pa.B. 2817]

   Under 28 Pa. Code § 1005.11 (relating to drug use, control and security), the following drugs are approved for use by ground advanced life support (ALS) ambulance services and may be administered by EMT-paramedics, prehospital registered nurses and health professional physicians when use of the drugs is permitted by the applicable Department of Health (Department) approved regional medical treatment protocols:

1. Adenosine
2. Albuterol
3. Amiodarone
4. Aspirin
5. Atropine sulfate
6. Benzocaine or benzocaine/tetracaine--for topical use only
7. Bretylium
8. Calcium chloride
9. Dexamethasone sodium phosphate
10. Diazepam
11. Diltiazem
12. Diphenhydramine HCL
13. Dobutamine--for interfacility transports only
14. Dopamine
15. Epinephrine HCL
16. Furosemide
17. Glucagon
18. Heparin by intravenous drip--for interfacility transports only
19. Heparin lock flush
20. Hydrocortisone sodium succinate
21. Glycoprotein IIb/IIIa Inhibitors--for interfacility transports only
   a.  Abciximab
   b.  Eptifibatide
   c.  Tirofiban
22. Intravenous electrolyte solutions
   a.  Dextrose
   b.  Lactated ringer's
   c.  Sodium chloride
   d.  Normosol
   e.  Potassium--for interfacility transports only
23. Isoproterenol HCL--for interfacility transports only
24. Lidocaine HCL
25. Lorazepam
26. Magnesium sulfate
27. Meperidine
28. Metaproterenol
29. Midazolam
30. Morphine sulfate
31. Naloxone HCL
32. Nitroglycerin by intravenous drip--for interfacility transports only
33. Nitroglycerin ointment
34. Nitroglycerin spray
35. Nitroglycerin sublingual tablets
36. Nitrous oxide
37. Oxytocin
38. Procainamide
39. Sodium bicarbonate
40. Sterile water for injection
41. Terbutaline
42. Verapamil

   This list supersedes the list of approved drugs published at 30 Pa.B. 6283 (December 2, 2000). Changes made are: (1) deletion of brand names; (2) deletion of aminophylline and droperidol; (3) addition of lorazepam and the intravenous electrolyte solution potassium for interfacility transports only; and (4) addition of ''for interfacility transports only'' designation on dobutamine and isoproterenol HCL. Ambulance services are not authorized to stock drugs designated ''for interfacility transports only.'' However, paramedics and health professionals may administer a drug so designated if the facility transferring a patient provides the drug, directs that it be administered to the patient during the transfer, and the regional transfer and medical treatment protocols permit the administration of the drug by those personnel.

   Section 1005.11 permits a ground ALS ambulance service to exceed, under specified circumstances, the drugs (taken from the master list) that a region's medical treatment protocols authorize for use within the region. In addition, under 28 Pa. Code § 1001.161 (relating to research), the Department may approve an ambulance service to engage in a research project that involves use of a drug not included in a region's medical treatment protocols. Finally, under to 28 Pa. Code § 1001.4 (relating to exceptions), a ground ALS ambulance service and its ALS service medical director may apply to the Department for an exception to a region's medical treatment protocols.

   The list of drugs in this notice does not apply to air ambulance services. Under to 28 Pa. Code § 1007.7(i)(2) (relating to licensure and general operating requirements), each air ambulance service is to develop its own medical treatment protocols which identify drugs that may be used by the air ambulance service. The air ambulance service is to then submit the protocols to the medical advisory committee of the appropriate regional emergency medical services council for the medical advisory committee's review and recommendations. Following its consideration of the recommendations, and after making further revisions if needed, the air ambulance service is to file the protocols with the Department for approval.

   Persons with a disability who require an alternate format of this notice (for example, large print, audiotape, Braille) should contact Robert Gaumer at the Department of Health, Emergency Medical Services Office, Room 1032, Health and Welfare Building, Harrisburg, PA 17120, (717) 787-8740, V/TT: (717) 783-6154 for speech or hearing impaired persons or the Pennsylvania AT&T Relay Service at (800) 654-5984 [TT].

ROBERT S. ZIMMERMAN, Jr.,   
Secretary

[Pa.B. Doc. No. 02-1002. Filed for public inspection June 7, 2002, 9:00 a.m.]


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