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PA Bulletin, Doc. No. 04-1371



Approved Drugs for ALS Ambulance Services

[34 Pa.B. 3987]

   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 supercedes the list of approved drugs published at 33 Pa.B. 2713 (June 7, 2003). Changes made are as follows:  (1) addition of levalbuterol for interfacility transports only; (2) addition of ipratropium bromide; and (3) change of benzocaine/tetracaine in combination to separate listings of benzocaine and tetracaine for topical use. 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 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 Robert Gaumer, Department of Health, Emergency Medical Services Office, Room 1032, Health and Welfare Building, Harrisburg, PA, 17120, (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).


[Pa.B. Doc. No. 04-1371. Filed for public inspection July 23, 2004, 9:00 a.m.]

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