ALS providers and EMS supervisors:
Effective immediately: Ketamine is on shortage for all concentrations and will not be stocked in the med pyxis for the next 4-6 weeks.
For pain management, please utilize fentanyl as your first line analgesic for moderate to severe pain unless it is contraindicated.
If you are going to use Ketamine, please use your current vials as a multi-dose vial. Attached is a tracking form that must be kept in each unit with each ketamine vial. Supervisors, make sure each unit gets a form printed out and assigned to each unit.
* The initial date will be when it was opened and the vial will be good for 30 days after that date. * Fill out the ketamine tracking form for that vial for each unit, for every use. * Only pull the amount needed for the dose to be administered. (Be careful to not inject too much air into the vial for increased pressurization that will result in spillage/waste.) * Make sure to clean the vial before and after each use, and keep vial in as clean storage area as possible. * Notify the EMS supervisor if you need larger doses than you have on hand for the severely agitated patient with the presence of imminent/immediate danger. * Notify the EMS supervisor when you have less than 2 ml left remaining in your vial.
EMS supervisors, I have a very limited amount for restock should the need arise. Keep close eye on your inventory on your units. If you have any questions or concerns, please let me know.
Effective immediately: Ketamine is on shortage for all concentrations and will not be stocked in the med pyxis for the next 4-6 weeks.
For pain management, please utilize fentanyl as your first line analgesic for moderate to severe pain unless it is contraindicated.
If you are going to use Ketamine, please use your current vials as a multi-dose vial. Attached is a tracking form that must be kept in each unit with each ketamine vial. Supervisors, make sure each unit gets a form printed out and assigned to each unit.
* The initial date will be when it was opened and the vial will be good for 30 days after that date. * Fill out the ketamine tracking form for that vial for each unit, for every use. * Only pull the amount needed for the dose to be administered. (Be careful to not inject too much air into the vial for increased pressurization that will result in spillage/waste.) * Make sure to clean the vial before and after each use, and keep vial in as clean storage area as possible. * Notify the EMS supervisor if you need larger doses than you have on hand for the severely agitated patient with the presence of imminent/immediate danger. * Notify the EMS supervisor when you have less than 2 ml left remaining in your vial.
EMS supervisors, I have a very limited amount for restock should the need arise. Keep close eye on your inventory on your units. If you have any questions or concerns, please let me know.
Please note: once you have used your 200 mg/20 ml vial, it will not be replaced. You will need to continue to use your 500 mg/10 ml concentration as a multi-dose vial.
Melanie Higgins, BS, NRP Captain – EMS Quality Assurance Division of Emergency Services 16232 Elliott Parkway Williamsport, MD 21795 (cell) 301-491-2454 (office) 240-313-4376 (fax) 240-313-4375
Ketamine-Multi-Dose-VialUNIT.docx