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Prevent controlled substance diversion with a digital record of entry

Careful monitoring, witnessed documentation and a record of any actions will protect controlled substances in the ambulance from theft


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Performing a daily medication check, a monthly rig check or a quarterly full ambulance inspection are common parts of our job in EMS. But having a surprise audit by the Drug Enforcement Agency (DEA) certainly isn’t something that we ever want happening within our agency.

Did we document when and where we got that vial of fentanyl? How about checking the expiration date on your ketamine vials? Can we accurately track each vial and container from “cradle to grave?”

A clipboard with multiple paper checklist copies can certainly serve as an initial line of documentation for medication tracking ... but are we really providing a secure method of controlled substance tracking though this option?

Narcotic and other controlled substance medication diversion issues have become a growing problem within our industry. (Photo/Greg Friese)
Narcotic and other controlled substance medication diversion issues have become a growing problem within our industry. (Photo/Greg Friese)

How about securing medications in an ambulance? Do you use a double-lock system that consists of pull tabs and tape? Or, do you use a more robust and reliable medication safe?

Narcotic and other controlled substance medication diversion issues have become a growing problem within our industry. Feeding one’s addiction by stealing from the ambulance’s stock can have negative effects on patient care, can increase agency liability, and can also lead to individual criminal charges.

So how do we combat this practice – or even better yet, how do we prevent it from even happening in the first place?

Here’s a few quick tips to provide some additional accountability and safety in terms of controlled substance storage for your EMS agency:

  • Have a secure system and routine for tracking medications.
  • Account for every medication container at the beginning of each shift.
  • Make sure every action is logged and documented by two providers.

Failing to accurately track controlled substances certainly has its own set of consequences, even leading up to fines in excess of $14,000. Initial inventory and biannual inventory audits must be performed, including physical counts of each controlled substance in stock.

Accurate controlled substance tracking and secure storage

All of this, of course, can be made much easier with these simple safeguards in place. Combining accurate tracking with secure storage can not only deter thefts from occurring, they can also protect your EMS agency from liability because of such diligent measures.

In terms of physical storage and tracking, here’s a few more recommendations to help keep your tracking in check:

  • Utilize a secure storage and locking system, both in the station and ambulance.
  • Keep all receipts for medication orders and receiving.
  • Maintain all tracking documents for at least two years, and be able to separate medications by schedule classification.

All too often, we hear about pain medications being diverted for personal use, unlocked ambulances being ransacked while parked at the scene of an emergency, and the growing rate of provider addiction to opiates and other recreational drugs. Doing your part as an agency to prevent, identify and react to these circumstances is paramount in today’s drug-sensitive climate.

Whether you’re a private, hospital or municipal-based EMS agency, the risk of drug diversion and theft is a concern that we all need to be aware of. Providing some simple safeguards to prevent this from occurring can go a long way to keep your patients, providers and agency as a whole safe.

Secure medication storage and accurate medication tracking can go a long way to have a positive impact on the opioid abuse epidemic that our nation and industry are facing.

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