NOTICES
DEPARTMENT OF HEALTH
Approved Drugs for ALS Ambulance Services
[43 Pa.B. 3060]
[Saturday, June 1, 2013]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 (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. Activated charcoal
2. Acetaminophen
3. Adenosine
4. Albuterol
5. Amiodarone
6. Antimicrobials—for interfacility transports only
7. Aspirin
8. Atropine sulfate
9. Benzocaine—for topical use only
10. Bivalirudin—for interfacility transports only
11. Calcium chloride
12. Calcium gluconate
13. Captopril
14 Dexamethasone sodium phosphate
15. Diazepam
16. Dilaudid—for interfacility transports only
17. Diltiazem
18. Diphenhydramine HCL
19. Dobutamine
20. Dopamine
21. Enalapril
22. Epinephrine HCL
23. Epinephrine, Racemic
24. Etomidate (only permitted for services approved by a regional EMS council and participating in the required QI program)
25. Fentanyl
26. Furosemide
27. Glucagon
28. Heparin by intravenous drip—for interfacility transports only
29. Hydrocortisone sodium succinate
30. Glycoprotein IIb/IIIa Inhibitors—for interfacility transports only
a. Abciximab
b. Eptifibatide
c. Tirofiban
31. Intravenous electrolyte solutions
a. Dextrose
b. Lactated Ringer's
c. Sodium chloride
d. Normosol
e. Potassium—for interfacility transports only
31. Ipratropium Bromide
32. Isoproterenol HCL—for interfacility transports only
33. Levalbuterol—for interfacility transports only
34. Lidocaine HCL
35. Lorazepam
36. Magnesium sulfate
37. Methylprednisolone
38. Midazolam
39. Morphine sulfate
40. Naloxone HCL
41. Nitroglycerin (all forms/routes, but continuous intravenous infusion must be regulated by an infusion pump)
42. Nitrous oxide
43. Ondansetron
44. Oxytocin
45. Pralidoxime CL
46. Procainamide
47. Sodium bicarbonate
48. Sodium thiosulfate
49. Sterile water for injection
50. Terbutaline
51. Tetracaine—for topical use only
52. Total parenteral nutrition—for interfacility transport only
53. Verapamil
During interfacility transport, all medications given by continuous infusion (except intravenous electrolyte solutions with potassium concentrations of no more than 20 mEq/L) must be regulated by an electronic infusion pump. For prehospital transport, continuous infusions of crystalloid solutions containing medication (except intravenous electrolyte solutions with potassium concentrations of no more than 20 mEq/L) must be rate controlled by electronic IV pump or a manual flow control device capable of setting specific numeric flow rates.
This list supersedes the list of approved drugs published at corrected 42 Pa.B. 4229 (July 7, 2012).
The following addition is the only change from the previous list:
1. The addition of racemic epinephrine.
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. See 28 Pa. Code § 1005.11(a)(3) and (d).
Section § 1005.11 of 28 Pa. Code 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.
The list of drugs in this notice does not apply to air ambulance services. Under 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 D. Cooney, EMS Program Manager, Bureau of Emergency Medical Services, Department of Health, Room 606, Health and Welfare Building, 625 Forster Street, Harrisburg, PA 17120-0701, (717) 787-8740. Speech or hearing impaired persons may use V/TT (717) 783-6154 or the Pennsylvania AT&T Relay Service at (800) 654-5984 (TT).
MICHAEL WOLF,
Secretary
[Pa.B. Doc. No. 13-1003. Filed for public inspection May 31, 2013, 9:00 a.m.]
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