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Approved Drugs for ALS Ambulance Service

[37 Pa.B. 1278]
[Saturday, March 17, 2007]

   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, 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.  Etomidate
18.  Fentanyl
19.  Furosemide
20.  Glucagon
21.  Heparin by intravenous drip--for interfacility transports only
22.  Heparin lock flush
23.  Hydrocortisone sodium succinate
24.  Glycoprotein IIb/IIIa Inhibitors--for interfacility transports only
a.  Abciximab
b.  Eptifibatide
c.  Tirofiban
25.  Intravenous electrolyte solutions
a.  Dextrose
b.  Lactated Ringer's
c.  Sodium chloride
d.  Normosol
e.  Potassium--for interfacility transports only
26.  Ipratropium Bromide
27.  Isoproterenol HCL--for interfacility transports only
28.  Levalbuterol--for interfacility transports only
29.  Lidocaine HCL
30.  Lorazepam
31.  Magnesium sulfate
32.  Metaproterenol
33.  Methylprednisolone
34.  Midazolam
35.  Morphine sulfate
36.  Naloxone HCL
37.  Nitroglycerin by intravenous drip--for interfacility transports only
38.  Nitroglycerin ointment
39.  Nitroglycerin spray
40.  Nitroglycerin sublingual tablets
41.  Nitrous oxide
42.  Ondansetron
43.  Oxytocin
44.  Pralidoxime CL
45.  Procainamide
46.  Sodium bicarbonate
47.  Sodium thiosulfate
48.  Sterile water for injection
49.  Terbutaline
50.  Tetracaine--for topical use only
51.  Verapamil

   This list supersedes the list of approved drugs published at 36 Pa.B. 8012 (December 30, 2006).

   Changes made are: (1) addition of ondansetron; and (2) removal of phenergan.

   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. 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, Braille) should contact Robert Cooney at the Department of Health, Bureau of Emergency Medical Services, Room 1032, Health and Welfare Building, 7th and Forster Streets 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).

CALVIN B. JOHNSON, M. D., M.P.H.,   
Secretary

[Pa.B. Doc. No. 07-461. Filed for public inspection March 16, 2007, 9:00 a.m.]



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