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PA Bulletin, Doc. No. 05-1486



Approved Drugs for ALS Ambulance Services

[35 Pa.B. 4373]

   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 emergency medical technician-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--for topical use only
  7.  Bretylium
  8.  Calcium chloride
  9.  Dexamethasone sodium phosphate
10.  Diazepam
11.  Dilaudid--for interfacility transports only
12.  Diltiazem
13.  Diphenhydramine HCL
14.  Dobutamine
15.  Dopamine
16.  Epinephrine HCL
17.  Fentanyl
18.  Furosemide
19.  Glucagon
20.  Heparin by intravenous drip--for interfacility transports only
21.  Heparin lock flush
22.  Hydrocortisone sodium succinate
23.  Glycoprotein IIb/IIIa Inhibitors--for interfacility transports only
      a.  Abciximab
      b.  Eptifibatide
      c.  Tirofiban
24.  Intravenous electrolyte solutions
      a.  Dextrose
      b.  Lactated Ringer's
      c.  Sodium chloride
      d.  Normosol
      e.  Potassium--for interfacility transports only
25.  Ipratropium bomide
26.  Isoproterenol HCL--for interfacility transports only
27.  Levalbuterol--for interfacility transports only
28.  Lidocaine HCL
29.  Lorazepam
30.  Magnesium sulfate
31.  Metaproterenol
32.  Methylprednisolone
33.  Midazolam
34.  Morphine sulfate
35.  Naloxone HCL
36.  Nitroglycerin by intravenous drip--for interfacility transports only
37.  Nitroglycerin ointment
38.  Nitroglycerin spray
39.  Nitroglycerin sublingual tablets
40.  Nitrous oxide
41.  Oxytocin
42.  Phenergan
43.  Pralidoxime CL
44.  Procainamide
45.  Sodium bicarbonate
46.  Sodium thiosulfate
47.  Sterile water for injection
48.  Terbutaline
49.  Tetracaine--for topical use only
50.  Verapamil

   This list supersedes the list of approved drugs published at 34 Pa.B. 3987 (July 24, 2004).

   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. 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 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 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 or Braille) should contact Andrew Gilger, Department of Health, Emergency Medical Services Office, Room 1032, Health and Welfare Building, Harrisburg, PA 17120, (717) 787-8740 or speech or hearing impaired persons may use V/TT: (717) 783-6154 or the Pennsylvania AT&T Relay Service at (800) 654-5984.


[Pa.B. Doc. No. 05-1486. Filed for public inspection August 5, 2005, 9:00 a.m.]

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