Tracking your Narcotics?

[Medic26]

I'm not so interested in how you carry them as much as I am how you record, track or verify that they are where they are supposed to be.

I recently started catching alot of "BS" from the rest of the guys when I brought back the policy that our drug bag integrity seals had to be checked each day and verified on a log sheet, this had only been done on the "back row" trucks once a week previously for the last 5 years or so. Our bags (thomas bags) have double locks with a break-away seal, stored in the cabinet...each day they are checked and logged, 10 minutes process.

So how is your narcs tracked and carried??

[Ridryder 911]

The Narcs are double locked and are counted each shift change. We do not use locking tags. Personally, although they are easier at shift time, I rather perform a count and witness my med.'s.

I question if they are not being routinely checked, then how are they being checked expiration, etc. As well, anytime there is shift change, Narc's should be accounted for. Otherwise why count?

R/r 911

[p3medic]

Every shift does a face to face drug count with the off going shift. All drug records are kept in a book with the lot # and expiration date. Two signatures go with the count in the book. Whenever a drug is used or returned to the pharmacy, two medics sign for the usage/waste or return. It is logged on the pcr, the log book and the controlled drug record issued by the pharmacy. This is only for controlled drugs.

[Just Plain Ruff]

I'm not so concerned about how they count but rather how are they documenting it if the DEA comes in to check?

How did your service get past the DEA inspections? I mean you have to have a controlled count of sign off and witnessing and periodic inspections happen.

Does your company falsify the records? How do they get around it?

I would think that your agency is a ticking time bomb when it comes to inspections. You are very right to push this issue.

In the end the medical directors license is on the line but your's is too. I'd be pushing it also.

Good luck

if they don't shape up why don't you place an anonymous call to the DEA and say My service doesn't count our narcs every shift and I think there might be some shenanigans happening. That would take balls bigger than the ones many of us have here but it would prompt a more stringent record keeping for the future.

[OVeractiveBrain]

I used two different types. In my more suburban job, we either handed off face to face with a log sheet (we carried ativan, morphine and versed). The narcs were sealed. If broken, they had to go back to the pharmacy at our local hospital (this was a community hospital). If we had no one to give them to at shift change, they went to the pharmacy or to a supervisor.

At my urban service, seals were on the plastic box they came in. If broken, they had to be exchanged at the hospital that gave us our narcs. Drugs were given over to the supervisor "behind the window" at shift change, and again, were signed in and out.

On the road it was up to us to take care of them. It was 100% acceptable and appropriate to take yourself offline to get your drugs refilled at the pharmacy

Overactive

[Ridryder 911]

I'm not so concerned about how they count but rather how are they documenting it if the DEA comes in to check?

In the end the medical directors license is on the line but your's is too. k

I have yet seen a DEA interaction in my 30+ years. I talked to DEA (medical division although any DEA can handle narc) and was informed that in my area there were 2 agents assigned for coverage of 10 states as well other assigned duties. Figuring that they are responsible for all hospitals, pharmacies, clinics, nursing homes, hospice, home health, EMS, etc I doubt, I would be seeing them, unless there was trouble. Usually, the state license agency may become more involved. Yet, I totally agree I would not test fate! Do narc counts properly and one does not have to worry.

If your service wants to still continue to have protocols for narc's as well being able to keep them, I would not endanger my medical directors DEA number ! I am sure informing them of what has been occurring, will get things changed immediately.

R/r 911

[fiznat]

We carry 2 "kits" in each truck, which are plastic boxes with break away seals and kept in a double-locked cabinet in the truck. The narcs are signed in and out by each crew in a log book, although I admit I don't often open to the cabinet to make sure they are there. If we use a kit or one expires, we have to go to a local hospital's pharmacy to exchange them, where they are again double signed-for.

I imagine it would be extremely hard to try and play games with narcotic drugs in this system. You might get away with it once or twice, but there are too many checks and balances- people would start catching on pretty quick.

[Eydawn]

I always always *always* verify narcotic/controlled substance drug counts MYSELF. Do not *ever* sign your name to a drug count or check that you didn't do- if something goes wrong, it makes you complicit. If you see a problem, report it to your supervisor immediately! Otherwise, when the crapola finally rolls down the mountain, you will be completely buried along with the rest of your coworkers.

Honestly! How long does it take to count/check the drugs or look at the seals? At my job, working with developmental disabilities, we physically shake out the client's pills and count them (wearing gloves and not touching the meds) or count them in their blister packs, and double sign the count. That's been the majority of my incident reports so far... funny controlled med counts. You wouldn't believe how many people just take the last shift's word for it, or just subtract whatever they've given to the pt. from the log sheet. BAD idea....

So, to re-iterate... check the box, count the vials or check the seal, and don't sign the paper until you do! It ensures your job safety, and helps the industry keep folks from abusing the narcs!

Wendy

CO EMT-B

[Medic26]

I'm not so concerned about how they count but rather how are they documenting it if the DEA comes in to check?

How did your service get past the DEA inspections? I mean you have to have a controlled count of sign off and witnessing and periodic inspections happen.

Does your company falsify the records? How do they get around it?

We exchange the bags through the local hospital pharmacy any time we use any medications, they verify and count everything....submit paperwork and so on. To be honest I'm not sure why ity hasn't come up in the past.

[CoyoteMedic]

Well, I work for a AMR division in California, we get our narcs at the start of the shift, since we work flex cars, from a service tech, who takes them out of a safe, which is under 24/7 video watch. They are sealed by a break-a-way seal. We verify the box number, get the corisponding binder, verify that the seal number is the same as when the last medic signed it off, or the supervisor restocked, and then lock it in a cabnet, which is lock one, and then my company considers locking the ambulance as lock number two. I don't agree with it, but its how they do it.