DEPARTMENT OF HEALTH Approved Drugs for ALS Ambulance Services [42 Pa.B. 4229] [Saturday, July 7, 2012]
Under 28 Pa.?Code § 1005.11(b) (relating to drug use, control and security), the following drugs areapproved for use by ground advanced life support (ALS) ambulance services and may be administered byemergency medical technicians—paramedics, prehospital registered nurses and health professionalphysicians when use of the drugs is permitted by the applicable Department of Health (Department)approved regional medical treatment protocols:
6. Antimicrobials—for interfacility transports only
10. Bivalirudin—for interfacility transports only
16. Dilaudid—for interfacility transports only
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23. Etomidate (only permitted for services approved by a regional EMS council and participating in therequired QI program)
27. Heparin by intravenous drip—for interfacility transports only
29. Glycoprotein IIb/IIIa Inhibitors—for interfacility transports only
e. Potassium—for interfacility transports only
32. Isoproterenol HCL—for interfacility transports only
33. Levalbuterol—for interfacility transports only
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41. Nitroglycerin (all forms/routes, but continuous intravenous infusion must be regulated by an infusionpump)
52. Total parenteral nutrition—for interfacility transport only
During interfacility transport, all medications given by continuous infusion (except intravenous electrolytesolutions with potassium concentrations of no more than 20 mEq/L) must be regulated by an electronicinfusion pump. For prehospital transport, continuous infusions of crystalloid solutions containingmedication (except intravenous electrolyte solutions with potassium concentrations of no more than 20mEq/L) must be rate controlled by electronic IV pump or a manual flow control device capable of settingspecific numeric flow rates.
This list supersedes the list of approved drugs published at 41 Pa.B. 2286 (April 30, 2011). The changesfrom the previous notice are:
2. The addition of prehospital transport continuous infusions of crystalloid solutions containing medication(except intravenous electrolyte solutions with potassium concentrations of no more than 20 mEq/L) mustbe rate controlled by an electronic IV pump or a manual flow control device capable of setting specificnumeric flow rates.
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 facilitytransferring 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 thosepersonnel. See 28 Pa.?Code § 1005.11(a)(3) and (d).
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Section 1005.11 of 28 Pa.?Code permits a ground ALS ambulance service, with Department approval, tostock drugs, under specified circumstances, in addition to those drugs on the approved list if a region'smedical treatment protocols authorize their 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 itsown medical treatment protocols that identify drugs that may be used by the air ambulance service. The airambulance service is to then submit the protocols to the medical advisory committee of the appropriateregional emergency medical services council for the medical advisory committee's review andrecommendations. Following its consideration of the recommendations and making further revisions ifneeded, 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 Cooney, Department of Health, Bureau of Emergency MedicalServices, 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&TRelay Service at (800) 654-5984 (TT). [Pa.B. Doc. No. 12-1270. Filed for public inspection July 6, 2012, 9:00 a.m.]
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