Inter-Facility Medication Administration

 

Policy:

 

  • Some patients may be required to be on a medication during transport. When this occurs, the inter-facility transport drugs must be initiated at the sending facility and the patient must be stabilized on the medication prior to transport.

 

 Purpose:

 

  • The Paramedic in charge of the call must also ensure that he/she has received adequate education and information on the inter-facility drugs to be transported with the patient (i.e., side effects, adverse reactions,  etc.) prior to accepting the patient for transfer. This information is to be documented on the Inter-facility Drug Transport Form.

 

Procedure:

 

  • When the crew arrives at the sending facility, they will receive a full verbal and written report. The Paramedic in charge of the call is responsible for accepting the patient and for ensuring that the appropriate documentation has been completed. The written report and all other documentation, including SC DHEC form 3485 (11/2010) necessary for transfer will accompany the patient.
  • Paramedics are not authorized to mix inter-hospital transport drugs. If it is anticipated that the intravenous (IV) therapy will run out during transport, an additional bag of fluid should be supplied, pre-mixed, and piggybacked into the existing IV infusion before or during transport. Paramedics are not authorized to initiate any additional units of whole blood or packed cells during transport.
  • When Sodium Nitroprusside, Magnesium Sulfate, and/or Nitroglycerine are being administered, a volumetric infusion pump and a noninvasive electronic blood pressure monitor are required during transport. Patients being transported on Mannitol require an indwelling urinary catheter to be in place prior to transport.
  • The Paramedic based upon signed, written orders of the sending physician will monitor drugs in transit. Only Paramedics are authorized to maintain these drugs.
  • During transfer of the patient on an inter-facility transport drug, the Paramedic may reduce or discontinue the drug in the event of adverse reaction or complication or upon the direction of on-line Medical Control. The Paramedic may increase the rate of administration only with on-line physician direction.
  • Time is of the essence in STEMI and stroke transfers. The goal is to have STEMI patients transferred within 30 minutes of arriving at a non-PCI center. To facilitate a quick transfer of patient care from the sending facility to EMS; North Greenville, Greer Memorial, and Hillcrest will attempt to have the patient on a Stryker Stretcher prior to EMS arrival.
  • In these cases, swap stretchers with the sending facility and accept the patient on the hospital’s EMS stretcher. Retrieve the EMS stretcher at the completion of the call when operationally feasible. Attempt to reduce all delays and begin transport as rapidly as possible.
  • At the completion of the call, scan the DHEC form 3485 and attach it to the electronic patient care report (PCR) in ESO. The hard copy can be placed in one of the secure green bags to be shredded. Additional forms, if needed, can be located on the “I” drive in the forms folder, attached to this document or in logistics.