RE: Drip Medications

January 5, 2005

There are no regulations against mixing drips and certainly JCAHO does not

apply to the prehospital setting. With that said, what is likely being

referred to is one of the National Patient Safety Goals, specifically 3b. I

have excerpted it below.

3) Improve the safety of using high-alert medications.

a) Remove concentrated electrolytes (including, but not limited to,

potassium chloride, potassium phosphate, sodium chloride >0.9%) from patient

care units. [scored at Standard MM.2.20, EP #9]

Standardize and limit the number of drug concentrations available in

the organization. [scored at Standard MM.2.20, EP #8]

Stacey Wyrick, MD

Drip Medications

I have recently been advised by my wife, who happens to be an RN; that it is

against regulations to mix medication drips, i.e., dopamine, Lidocaine,

etc..

She states that OSHA and JACHO have made this a regulation. Is this

happening in EMS or are we behind like usual?

Danny L.

Owner/NREMT-P

Panhandle Emergency Training Services And Response

(PETSAR)

Office

FAX

January 5, 2005

We see that all the time in dealing with the hospitals. We try

to convince them our ASHI BLS and ACLS classes are as high or

higher quality than the comparable AHA courses, and with lower

cost materials, and we're often told " JCAHO requires AHA " . Which,

of course, is NOT true, JCAHO just says you have to have the

training, not which agency you teach. We even got a letter from

JCAHO to that effect, that quotes their standard, but still people

use them as an excuse to do what they want.

=Steve=

Steve , LP

AlertCPR Emergency Training

2300 Highland Village Rd, Suite 340

Highland Village, TX 75077

>--- Original Message ---

>From: lnmolino@...

>To:

>Date: 1/5/05 6:22:37 AM

>

>In a message dated 1/5/2005 11:19:31 A.M. Central Standard Time,

>je.hill@... writes:

>

>One more thing I noted from working in the hospital environment,

it was very

>common for administration to pass new rules about any number

of things and

>then blame the changes on JCAHO or other agencies. Sometimes

it was true,

>sometimes it was just an attempt to justify the change with

as few complication

>as possible with the staff.

>

>NOW that I agree with 100%

>

>Blame someone lese is a stand alone management style I think!

>

>Louis N. Molino, Sr., CET

>FF/NREMT-B/FSI/EMSI

>LNMolino@...

> (Home Office)

> (Cell Phone)

> (TEEX Office)

>

> " A Texan with a Jersey Attitude "

>

>The comments contained in this E-mail are the opinions of the

author and the

>author alone. I in no way ever intend to speak for any person

or

>organization that I am in any way whatsoever involved or associated

with unless I

>specifically state that I am doing so. Further this E-mail

is intended only for its

>stated recipient and may contain private and or confidential

materials

>retransmission is strictly prohibited unless placed in the

public domain by the

>original author.

>

January 5, 2005

We see that all the time in dealing with the hospitals. We try

to convince them our ASHI BLS and ACLS classes are as high or

higher quality than the comparable AHA courses, and with lower

cost materials, and we're often told " JCAHO requires AHA " . Which,

of course, is NOT true, JCAHO just says you have to have the

training, not which agency you teach. We even got a letter from

JCAHO to that effect, that quotes their standard, but still people

use them as an excuse to do what they want.

=Steve=

Steve , LP

AlertCPR Emergency Training

2300 Highland Village Rd, Suite 340

Highland Village, TX 75077

>--- Original Message ---

>From: lnmolino@...

>To:

>Date: 1/5/05 6:22:37 AM

>

>In a message dated 1/5/2005 11:19:31 A.M. Central Standard Time,

>je.hill@... writes:

>

>One more thing I noted from working in the hospital environment,

it was very

>common for administration to pass new rules about any number

of things and

>then blame the changes on JCAHO or other agencies. Sometimes

it was true,

>sometimes it was just an attempt to justify the change with

as few complication

>as possible with the staff.

>

>NOW that I agree with 100%

>

>Blame someone lese is a stand alone management style I think!

>

>Louis N. Molino, Sr., CET

>FF/NREMT-B/FSI/EMSI

>LNMolino@...

> (Home Office)

> (Cell Phone)

> (TEEX Office)

>

> " A Texan with a Jersey Attitude "

>

>The comments contained in this E-mail are the opinions of the

author and the

>author alone. I in no way ever intend to speak for any person

or

>organization that I am in any way whatsoever involved or associated

with unless I

>specifically state that I am doing so. Further this E-mail

is intended only for its

>stated recipient and may contain private and or confidential

materials

>retransmission is strictly prohibited unless placed in the

public domain by the

>original author.

>

January 5, 2005

We see that all the time in dealing with the hospitals. We try

to convince them our ASHI BLS and ACLS classes are as high or

higher quality than the comparable AHA courses, and with lower

cost materials, and we're often told " JCAHO requires AHA " . Which,

of course, is NOT true, JCAHO just says you have to have the

training, not which agency you teach. We even got a letter from

JCAHO to that effect, that quotes their standard, but still people

use them as an excuse to do what they want.

=Steve=

Steve , LP

AlertCPR Emergency Training

2300 Highland Village Rd, Suite 340

Highland Village, TX 75077

>--- Original Message ---

>From: lnmolino@...

>To:

>Date: 1/5/05 6:22:37 AM

>

>In a message dated 1/5/2005 11:19:31 A.M. Central Standard Time,

>je.hill@... writes:

>

>One more thing I noted from working in the hospital environment,

it was very

>common for administration to pass new rules about any number

of things and

>then blame the changes on JCAHO or other agencies. Sometimes

it was true,

>sometimes it was just an attempt to justify the change with

as few complication

>as possible with the staff.

>

>NOW that I agree with 100%

>

>Blame someone lese is a stand alone management style I think!

>

>Louis N. Molino, Sr., CET

>FF/NREMT-B/FSI/EMSI

>LNMolino@...

> (Home Office)

> (Cell Phone)

> (TEEX Office)

>

> " A Texan with a Jersey Attitude "

>

>The comments contained in this E-mail are the opinions of the

author and the

>author alone. I in no way ever intend to speak for any person

or

>organization that I am in any way whatsoever involved or associated

with unless I

>specifically state that I am doing so. Further this E-mail

is intended only for its

>stated recipient and may contain private and or confidential

materials

>retransmission is strictly prohibited unless placed in the

public domain by the

>original author.

>

January 5, 2005

The following is from the FDA Guidelines for Hospital Pharmacy

Operations. I also teach a pharmacy tech course which provides this

information. This is for hospitals only and does not apply to EMS.

Example of Good Repackaging(Medication Added)Practice Guidelines:

Drugs and Labels - All must be prepared and checked by a registered

pharmacist.

Equipment - Sterile compounding area in good working order.

Expiration Date - 6 months or 1/4 of the time of the drug's

manufacturing date whichever is less . The bulk of the container may

not have been previously opened.

Package - Appropriate for the drug

Preparation - Not more than one item prepared at a time.

Records - All items must repackaged logged for referencing.

Obviously, as a good practice guideline, all of this is wide open to

interpretation by each facility. I can see where one might interpret a

FDA guideline as a Joint Commission guideline.

Mike Hudson

>>> mhudson@... 01/05/05 11:36 AM >>>

There are JCH regulations in place that state all medications that are

mixed or componded must be done so by pharmacy personnel only.

Mike Hudson

>>> jamesdav@... 01/05/05 11:19 AM >>>

I have never heard of such a thing as this. Lots of ems agencies still

use do not carry pre-mixed dopamine and lidocaine drips . we used them

for adults but have to mix lido. Drip in a buretrol for pediatric post

resuscitation.

B. , AAS, LP

Baylor Regional Medical Center at Grapevine

EMS Educator

Baylor EMS Medical Control

1601 Lancaster Drive Suite #10

Grapevine, Tx 76051-3300

Office

Direct Line

Fax

Cell

Pager

Drip Medications

I have recently been advised by my wife, who happens to be an RN; that

it is

against regulations to mix medication drips, i.e., dopamine,

Lidocaine,

etc..

She states that OSHA and JACHO have made this a regulation. Is this

happening in EMS or are we behind like usual?

Danny L.

Owner/NREMT-P

Panhandle Emergency Training Services And Response

(PETSAR)

Office

FAX

January 5, 2005

The following is from the FDA Guidelines for Hospital Pharmacy

Operations. I also teach a pharmacy tech course which provides this

information. This is for hospitals only and does not apply to EMS.

Example of Good Repackaging(Medication Added)Practice Guidelines:

Drugs and Labels - All must be prepared and checked by a registered

pharmacist.

Equipment - Sterile compounding area in good working order.

Expiration Date - 6 months or 1/4 of the time of the drug's

manufacturing date whichever is less . The bulk of the container may

not have been previously opened.

Package - Appropriate for the drug

Preparation - Not more than one item prepared at a time.

Records - All items must repackaged logged for referencing.

Obviously, as a good practice guideline, all of this is wide open to

interpretation by each facility. I can see where one might interpret a

FDA guideline as a Joint Commission guideline.

Mike Hudson

>>> mhudson@... 01/05/05 11:36 AM >>>

There are JCH regulations in place that state all medications that are

mixed or componded must be done so by pharmacy personnel only.

Mike Hudson

>>> jamesdav@... 01/05/05 11:19 AM >>>

I have never heard of such a thing as this. Lots of ems agencies still

use do not carry pre-mixed dopamine and lidocaine drips . we used them

for adults but have to mix lido. Drip in a buretrol for pediatric post

resuscitation.

B. , AAS, LP

Baylor Regional Medical Center at Grapevine

EMS Educator

Baylor EMS Medical Control

1601 Lancaster Drive Suite #10

Grapevine, Tx 76051-3300

Office

Direct Line

Fax

Cell

Pager

Drip Medications

I have recently been advised by my wife, who happens to be an RN; that

it is

against regulations to mix medication drips, i.e., dopamine,

Lidocaine,

etc..

She states that OSHA and JACHO have made this a regulation. Is this

happening in EMS or are we behind like usual?

Danny L.

Owner/NREMT-P

Panhandle Emergency Training Services And Response

(PETSAR)

Office

FAX

January 5, 2005

The following is from the FDA Guidelines for Hospital Pharmacy

Operations. I also teach a pharmacy tech course which provides this

information. This is for hospitals only and does not apply to EMS.

Example of Good Repackaging(Medication Added)Practice Guidelines:

Drugs and Labels - All must be prepared and checked by a registered

pharmacist.

Equipment - Sterile compounding area in good working order.

Expiration Date - 6 months or 1/4 of the time of the drug's

manufacturing date whichever is less . The bulk of the container may

not have been previously opened.

Package - Appropriate for the drug

Preparation - Not more than one item prepared at a time.

Records - All items must repackaged logged for referencing.

Obviously, as a good practice guideline, all of this is wide open to

interpretation by each facility. I can see where one might interpret a

FDA guideline as a Joint Commission guideline.

Mike Hudson

>>> mhudson@... 01/05/05 11:36 AM >>>

There are JCH regulations in place that state all medications that are

mixed or componded must be done so by pharmacy personnel only.

Mike Hudson

>>> jamesdav@... 01/05/05 11:19 AM >>>

I have never heard of such a thing as this. Lots of ems agencies still

use do not carry pre-mixed dopamine and lidocaine drips . we used them

for adults but have to mix lido. Drip in a buretrol for pediatric post

resuscitation.

B. , AAS, LP

Baylor Regional Medical Center at Grapevine

EMS Educator

Baylor EMS Medical Control

1601 Lancaster Drive Suite #10

Grapevine, Tx 76051-3300

Office

Direct Line

Fax

Cell

Pager

Drip Medications

I have recently been advised by my wife, who happens to be an RN; that

it is

against regulations to mix medication drips, i.e., dopamine,

Lidocaine,

etc..

She states that OSHA and JACHO have made this a regulation. Is this

happening in EMS or are we behind like usual?

Danny L.

Owner/NREMT-P

Panhandle Emergency Training Services And Response

(PETSAR)

Office

FAX

January 5, 2005

I think I agree with those goals, Dr. Wyrick. I can definitely see those

things.

Jane Hill

--------- Drip Medications

I have recently been advised by my wife, who happens to be an RN; that it is

against regulations to mix medication drips, i.e., dopamine, Lidocaine,

etc..

She states that OSHA and JACHO have made this a regulation. Is this

happening in EMS or are we behind like usual?

Danny L.

Owner/NREMT-P

Panhandle Emergency Training Services And Response

(PETSAR)

Office

FAX

January 5, 2005

I think I agree with those goals, Dr. Wyrick. I can definitely see those

things.

Jane Hill

--------- Drip Medications

I have recently been advised by my wife, who happens to be an RN; that it is

against regulations to mix medication drips, i.e., dopamine, Lidocaine,

etc..

She states that OSHA and JACHO have made this a regulation. Is this

happening in EMS or are we behind like usual?

Danny L.

Owner/NREMT-P

Panhandle Emergency Training Services And Response

(PETSAR)

Office

FAX

January 5, 2005

I think I agree with those goals, Dr. Wyrick. I can definitely see those

things.

Jane Hill

--------- Drip Medications

I have recently been advised by my wife, who happens to be an RN; that it is

against regulations to mix medication drips, i.e., dopamine, Lidocaine,

etc..

She states that OSHA and JACHO have made this a regulation. Is this

happening in EMS or are we behind like usual?

Danny L.

Owner/NREMT-P

Panhandle Emergency Training Services And Response

(PETSAR)

Office

FAX

January 5, 2005

It is amazing how sometimes these things get stretched. You have to wonder on

the " why's " of this sort of thing and what the REAL motivations are.

Jane Hill

-------------- Original message from " Steve , LP " :

--------------

We see that all the time in dealing with the hospitals. We try

to convince them our ASHI BLS and ACLS classes are as high or

higher quality than the comparable AHA courses, and with lower

cost materials, and we're often told " JCAHO requires AHA " . Which,

of course, is NOT true, JCAHO just says you have to have the

training, not which agency you teach. We even got a letter from

JCAHO to that effect, that quotes their standard, but still people

use them as an excuse to do what they want.

=Steve=

Steve , LP

AlertCPR Emergency Training

2300 Highland Village Rd, Suite 340

Highland Village, TX 75077

>--- Original Message ---

>From: lnmolino@...

>To:

>Date: 1/5/05 6:22:37 AM

>

>In a message dated 1/5/2005 11:19:31 A.M. Central Standard Time,

>je.hill@... writes:

>

>One more thing I noted from working in the hospital environment,

it was very

>common for administration to pass new rules about any number

of things and

>then blame the changes on JCAHO or other agencies. Sometimes

it was true,

>sometimes it was just an attempt to justify the change with

as few complication

>as possible with the staff.

>

>NOW that I agree with 100%

>

>Blame someone lese is a stand alone management style I think!

>

>Louis N. Molino, Sr., CET

>FF/NREMT-B/FSI/EMSI

>LNMolino@...

> (Home Office)

> (Cell Phone)

> (TEEX Office)

>

> " A Texan with a Jersey Attitude "

>

>The comments contained in this E-mail are the opinions of the

author and the

>author alone. I in no way ever intend to speak for any person

or

>organization that I am in any way whatsoever involved or associated

with unless I

>specifically state that I am doing so. Further this E-mail

is intended only for its

>stated recipient and may contain private and or confidential

materials

>retransmission is strictly prohibited unless placed in the

public domain by the

>original author.

>

January 5, 2005

It is amazing how sometimes these things get stretched. You have to wonder on

the " why's " of this sort of thing and what the REAL motivations are.

Jane Hill

-------------- Original message from " Steve , LP " :

--------------

We see that all the time in dealing with the hospitals. We try

to convince them our ASHI BLS and ACLS classes are as high or

higher quality than the comparable AHA courses, and with lower

cost materials, and we're often told " JCAHO requires AHA " . Which,

of course, is NOT true, JCAHO just says you have to have the

training, not which agency you teach. We even got a letter from

JCAHO to that effect, that quotes their standard, but still people

use them as an excuse to do what they want.

=Steve=

Steve , LP

AlertCPR Emergency Training

2300 Highland Village Rd, Suite 340

Highland Village, TX 75077

>--- Original Message ---

>From: lnmolino@...

>To:

>Date: 1/5/05 6:22:37 AM

>

>In a message dated 1/5/2005 11:19:31 A.M. Central Standard Time,

>je.hill@... writes:

>

>One more thing I noted from working in the hospital environment,

it was very

>common for administration to pass new rules about any number

of things and

>then blame the changes on JCAHO or other agencies. Sometimes

it was true,

>sometimes it was just an attempt to justify the change with

as few complication

>as possible with the staff.

>

>NOW that I agree with 100%

>

>Blame someone lese is a stand alone management style I think!

>

>Louis N. Molino, Sr., CET

>FF/NREMT-B/FSI/EMSI

>LNMolino@...

> (Home Office)

> (Cell Phone)

> (TEEX Office)

>

> " A Texan with a Jersey Attitude "

>

>The comments contained in this E-mail are the opinions of the

author and the

>author alone. I in no way ever intend to speak for any person

or

>organization that I am in any way whatsoever involved or associated

with unless I

>specifically state that I am doing so. Further this E-mail

is intended only for its

>stated recipient and may contain private and or confidential

materials

>retransmission is strictly prohibited unless placed in the

public domain by the

>original author.

>

January 5, 2005

It is amazing how sometimes these things get stretched. You have to wonder on

the " why's " of this sort of thing and what the REAL motivations are.

Jane Hill

-------------- Original message from " Steve , LP " :

--------------

We see that all the time in dealing with the hospitals. We try

to convince them our ASHI BLS and ACLS classes are as high or

higher quality than the comparable AHA courses, and with lower

cost materials, and we're often told " JCAHO requires AHA " . Which,

of course, is NOT true, JCAHO just says you have to have the

training, not which agency you teach. We even got a letter from

JCAHO to that effect, that quotes their standard, but still people

use them as an excuse to do what they want.

=Steve=

Steve , LP

AlertCPR Emergency Training

2300 Highland Village Rd, Suite 340

Highland Village, TX 75077

>--- Original Message ---

>From: lnmolino@...

>To:

>Date: 1/5/05 6:22:37 AM

>

>In a message dated 1/5/2005 11:19:31 A.M. Central Standard Time,

>je.hill@... writes:

>

>One more thing I noted from working in the hospital environment,

it was very

>common for administration to pass new rules about any number

of things and

>then blame the changes on JCAHO or other agencies. Sometimes

it was true,

>sometimes it was just an attempt to justify the change with

as few complication

>as possible with the staff.

>

>NOW that I agree with 100%

>

>Blame someone lese is a stand alone management style I think!

>

>Louis N. Molino, Sr., CET

>FF/NREMT-B/FSI/EMSI

>LNMolino@...

> (Home Office)

> (Cell Phone)

> (TEEX Office)

>

> " A Texan with a Jersey Attitude "

>

>The comments contained in this E-mail are the opinions of the

author and the

>author alone. I in no way ever intend to speak for any person

or

>organization that I am in any way whatsoever involved or associated

with unless I

>specifically state that I am doing so. Further this E-mail

is intended only for its

>stated recipient and may contain private and or confidential

materials

>retransmission is strictly prohibited unless placed in the

public domain by the

>original author.

>

January 5, 2005

We seemed to be missing how this thread started. It was stated that this

was an OSHA mandate. I have done a quick search of the OSHA regs and was

unable to locate anything. Would someone please quote the specific OSHA

regulation so we can put this to rest?

Greg Higgins

January 5, 2005

We seemed to be missing how this thread started. It was stated that this

was an OSHA mandate. I have done a quick search of the OSHA regs and was

unable to locate anything. Would someone please quote the specific OSHA

regulation so we can put this to rest?

Greg Higgins

January 5, 2005

We seemed to be missing how this thread started. It was stated that this

was an OSHA mandate. I have done a quick search of the OSHA regs and was

unable to locate anything. Would someone please quote the specific OSHA

regulation so we can put this to rest?

Greg Higgins

January 5, 2005

On a similar vein, I've noticed that management often " creates " a mythical

regulation to prevent doing something they didn't want done.

So far, I've noticed the following people " won't let us do that. "

1) JCAHO

2) OSHA

3) TDH (now DSHS)

4) Our insurance company

5) Our attorneys (my personal favorite)

And of course, reasons of " homeland security " and " HIPPA " are cited as well.

Often, the REAL reason is that the person quoting policy, laws, or regulations

just doesn't want to do it.

-Wes Ogilvie, MPA, JD, EMT

Disclaimer -- as an attorney, I've probably been indirectly blamed for something

not happening.

January 5, 2005

On a similar vein, I've noticed that management often " creates " a mythical

regulation to prevent doing something they didn't want done.

So far, I've noticed the following people " won't let us do that. "

1) JCAHO

2) OSHA

3) TDH (now DSHS)

4) Our insurance company

5) Our attorneys (my personal favorite)

And of course, reasons of " homeland security " and " HIPPA " are cited as well.

Often, the REAL reason is that the person quoting policy, laws, or regulations

just doesn't want to do it.

-Wes Ogilvie, MPA, JD, EMT

Disclaimer -- as an attorney, I've probably been indirectly blamed for something

not happening.

January 5, 2005

Unless it was NOT SUPPOSED to happen, in which case you have

been blamed because it did happen.

Maxine Pate

---- Original message ----

>Date: Wed, 05 Jan 2005 15:52:20 -0500

>From: ExLngHrn@...

>

> -Wes Ogilvie, MPA, JD, EMT

>

> Disclaimer -- as an attorney, I've probably been

> indirectly blamed for something not happening.

>

January 5, 2005

Unless it was NOT SUPPOSED to happen, in which case you have

been blamed because it did happen.

Maxine Pate

---- Original message ----

>Date: Wed, 05 Jan 2005 15:52:20 -0500

>From: ExLngHrn@...

>

> -Wes Ogilvie, MPA, JD, EMT

>

> Disclaimer -- as an attorney, I've probably been

> indirectly blamed for something not happening.

>

January 5, 2005

Unless it was NOT SUPPOSED to happen, in which case you have

been blamed because it did happen.

Maxine Pate

---- Original message ----

>Date: Wed, 05 Jan 2005 15:52:20 -0500

>From: ExLngHrn@...

>

> -Wes Ogilvie, MPA, JD, EMT

>

> Disclaimer -- as an attorney, I've probably been

> indirectly blamed for something not happening.

>

January 5, 2005

Danny,

As someone who will be a pharmacist soon, I can assure you that neither OSHA

or JACHO can or will mandate this. This is probably someone's

misinterpretation of a hospital policy (encouraged by JACHO and ASHP

[American Society of Health System Pharmacists]) that states something along

the line that " the pharmacy staff will mix all infusions except those mixed

at the bedside during emergencies. " While on a clinical rotation, I recently

took a phone call from a staff nurse with a similar question and she was

quite sure that was what her manager told her. We talked the manager and had

actually discussed it with the Charge nurse who passed it on, and in two

steps, the commuication got garbled.

ASHP annually publishes a book called " Best Practices for Health-System

Pharmacy. " It defines three levels of risk in compounding IV infusions in an

institution (level 1 has the least stringent requirements for making sterile

products; level 3 the highest). In order to meet the level 1 requirements, a

laminar flow hood creating a Class 100 cleanroom environment is necessary

(class 100 means fewer than 100 particles of 0.5micrometers per cubic foot

of air) plus other requirements. The point of this is that IVs compounded in

a cleanroom environment are less likely to be contaminated than those

prepared outside of a cleanroom. In addition, it allows the extra step of

order verification prior to the product reaching the patient (current Best

Practices (ASHP and JACHO) do NOT require a pharmacist's verification if the

ordering provider (physician, NP, PA, stretch this a bit to include EMT-P)

is physically present when the medication is given; this means EDs (and by

extention ambulances) are generally exempt from pharmacist verification

rules. It is still a good idea to mix any infusion in a cleanroom, so in my

mind that suggests the BEST PRACTICE, but not the rule, would be to use

pre-mixed infusions.

There is a new set of Best Practices promulgated by the United States

Pharmacopeial Convention <USP 28 Chapter 797> That does have an exemption

that fits here: from http://www.usp.org/standards/proposed797Revisions.html

" Immediate Use Exemption (after Low-Risk Conditions- within the Low-Risk

Level CSPs section)

Three or fewer sterile products may be prepared in worse than ISO Class 5

air when there is no direct contact contamination, and administration begins

within 1 hour and is completed within 12 hours of preparation. [This

exemption has been honored by the JCAHO in 2004]. "

{ISO Class 5 air is equivalent to class 100 air}.

..I hope this is useful,

Nile

=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=

J. Nile , LP

PharmD Candidate (May 2005)

The University of Texas at Austin

& The University of Texas Health Science Center at San

E-mail: jnbarnes@...

Phone:

Pager:

=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=

Drip Medications

>

> I have recently been advised by my wife, who happens to be an RN; that it

is

> against regulations to mix medication drips, i.e., dopamine, Lidocaine,

etc..

> She states that OSHA and JACHO have made this a regulation. Is this

> happening in EMS or are we behind like usual?

>

> Danny L.

> Owner/NREMT-P

> Panhandle Emergency Training Services And Response

> (PETSAR)

> Office

> FAX

>

January 5, 2005