APPENDIX WHO CAN GIVE WHAT? Administration and Supply of Emergency Clinician Authorisation Key to Exemptions from legislation: NPP Non Parenteral POM. Can be given according to a protocol. 7 HMR 0, Schedule 7, Part (8). Exemption for s 9 HMR 0 Schedule 9 Exemption for anyone saving a life in an emergency. ACA ECA Activated Charcoal (NPP) O O O O Adenosine 6mg/ml injection DOCTOR ONLY (No verbal orders) Adrenaline :,000 - Anaphylaxis (IM) (9) O O P O P P Adrenaline :,000 - lifethreatening asthma (7) O O O O O O O P Adrenaline :,000 - Croup (nebulised) (NPP) O O O O O O Adrenaline :0,000 (7) Enhanced Skill O O O Amethocaine 0.5% eye drops PGD O O O P PGD (NPP) O O O O O O O Page 6 of 7
Amiodarone 00mg Cardiac Arrest (7) O O Enhanced Skill l O O O O P PGD Amiodarone 00mg BCT (7 with protocol) O O O O O O O PGD Aspirin 00mg Tablets - Chest Pain (NPP) O O P O Aspirin 00mg Tablets TIA (Supply) Administer first dose on scene Atropine Sulphate mg/5ml or P P O O O O O O O PGD PGD mg/0ml (9) O O O O P P Atropen (emergency antidote) (9) O P P P P P P P P Benzylpenicillin 600mg (7) O O O O O O O P PGD Bupivicaine 0.5% Injection DOCTOR ONLY (No Verbal Orders) Calcium Chloride 0% injection O O O O O O O PGD PGD Cefotaxime g Injection O O O O O O O PGD PGD Ceftriaxone g Injection O O O O O O O PGD PGD Chlorphenamine 0mg/ml Injection (9) O O P O P P Cyclizine 50mg/ml injection O O O O O O O PGD PGD Dexamethasone liquid mg/5ml (NPP) O O O O Page 6 of 7
Diazemuls 5mg/ml injection (7) O O O O O O O P PGD Diazepam Rectal.5mg/.5ml (NPP) O O O O O O O Diazepam Rectal 5mg/.5ml (NPP) O O O O O O O Dicobalt edetate injection CRBN (9) O P P P P P P P P Entonox (NPP) P P Etomidate mg/0ml DOCTOR ONLY (No Verbal Orders) P P P P P Flumazenil 500micrograms in 5ml O O O O O O O PGD PGD Fluorescein % eye drops or Fluorets (NPP) O O O O O O O Furosemide Injection 50mg/5ml (7) O O O O O O O P PGD Glucagon mg (9) O O P O Glucagel mg (NPP) O O P P P P P Glucose Infusion 5% 50ml (9) (9) O O O O O O O P P Glucose Infusion 0% 500ml (9) (9) O O O O P P Glycopyrrolate 00mcg injection O O O O O O O PSD PSD GTN Spray 00mcg (NPP) O O P P P Page 65 of 7
Heparin 5000 iu/ml injection O O O O O O O PGD PGD Hydrocortisone 00mg injection (9) O O P O Hyoscine-N-Butylbromide 0mg in P P ml Injection O O O O O O O PSD PSD Hyoscine 00mcg Injection (Hydrobromide) O O O O O O O PSD PSD Ibuprofen sachets and suspension (NPP) O O P Ipratropium 50mcg/ml nebule (NPP) O O P P P P P Ketamine 0mg/ml 5 O O O O O O O PGD PGD Levonorgestrel 500mg Tablet (NPP) O O O O O O O Lidocaine % injection (suturing) O O O O O O O PGD PGD Lidocaine % preservative free injection (IO) O O O O O O O PGD PGD Lorazepam tablets and injection DOCTOR ONLY (Only doctors have the legal authority to possess) Magnesium sulphate injection 50% O O O O O O O PGD PGD Metaraminol.5mg in 5ml injection DOCTOR ONLY (No Verbal Orders) Metoclopramide 0mg/ml Injection Emergency Care (7) O O O O O O O P PGD Page 66 of 7
Metoclopramide 0mg/ml Injection Palliative Care O O O O O O O PSD PSD Midazolam buccal or intranasal 5 Patient s Own Supply O O PSD O O O PSD PSD PSD Midazolam buccal O O O O O O O PGD PGD Midazolam mg/5ml (5ml) injection O O O O O O O 5 PGD PGD Midazolam 0mg/ml (ml) injection 5 (Palliative care only. No O O O O O O O PSD PSD syringe drivers)) Misoprostol tablets (NPP) O O O P P Morphine sulphate 0mg injection 5 O O O O O O O P PGD Morphine sulphate 0mg in 5ml oral solution (NPP) O O O O O O O Naloxone (Including intra-nasal) (9) O O P O Ondansetron injection mg/ml P P (7) O O O O O O O P PGD Oxygen (NPP) P P P P P P P P P Paracetamol g injection (7) O O O O O O O PGD Paracetamol Susp 0mg/5ml/sachets O O P Paracetamol Susp 50mg/5ml/sachets O O P P P P P Page 67 of 7
Paracetamol tablets 500mg O O P P P Phytomenadione 0mg/ml injection DOCTOR ONLY Pralidoxime Chloride (Combo-pen emergency antidote) (9) O P P P P P P P P Prednisolone 5mg tablets (Supply) O O O O O O O PGD PGD Prochlorperazine.5mg injection O O O O O O O PGD PGD Procyclidine 0mg/ml injection DOCTOR ONLY Promethazine (Rapid tranquillisation) 5mg/ml O O O O O O O PGD PGD Propofol 0mg/ml injection DOCTOR ONLY (No Verbal Orders) Revaxis injection O O O O O O O PGD PGD Rocuronium 0mg/ml DOCTOR ONLY Salbutamol 500micrograms in ml Injection Salbutamol.5mg/.5ml Nebules (NPP) O O P DOCTOR ONLY P P Sodium bicarbonate 8.% injection O O O O O O O PGD PGD Sodium Chloride 0.9% 0ml (7) O O O O O O O P PGD Sodium Chloride 0.9% 5ml Pre-filled for flushing O O P O 6 P P Page 68 of 7
Sodium Chloride 0.9% 500ml (7) O O O O O O O P PGD Sodium Chloride 5% (Hypertonic saline) 500ml O O O O O O O 7 Tenecteplase 0,000u injection (7) O O O O O O O P PGD 7 7 Tetracaine gel % (NPP) O O O O O O O Tranexamic Acid 500mg/5ml O O O O O O O PGD PGD Tropicamide 0.5% eye drops (NPP) O O O O O O O Water for injection (unless as a diluent) O O O O O O O PGD PGD Page 69 of 7
Notes. Doctors present on scene may direct a registered paramedic or registered nurse to administer a dose, which they have prescribed. The registered clinician must administer under the direct supervision of that doctor during the administration.. HMR 0, Schedule 7, Part (9): s who hold a current UK Resuscitation Council Life Support certificate and have received authorisation following an application to practice skills under the enhanced skills policy may administer these drugs during a cardiac arrest. The administration shall be involving cardiac arrest, and in the case of adrenaline the administration shall be intravenous only. Amiodarone is limited to a bolus during a cardiac arrest. s who hold a current UK Resuscitation Council Life Support certificate do not need to sign a PGD for these drugs. Amiodarone is authorised for administration both during a cardiac arrest and for symptomatic VT.. The is required for symptomatic VT. The paramedic is still saving a life in an emergency but this is peri-arrest.. Drugs in purple box are supplied to patients but first dose is administered on scene. 5. Drugs in orange are Schedule or drugs under the Misuse of Drugs Regulations 00. NO VERBAL ORDERS can be received or given for these drugs. (Ketamine will be added to Schedule on 0 th November 05) 6. Pre-filled syringes are for flushing an IV or IO cannula in the absence of a registered clinician- they must not be used to dilute medicines. 7. Hypertonic saline administration authorised by a doctor (verbal order) but administration must followed medicines protocol. General points: refers to administration under the direct clinical supervision of a clinician authorised to administer the medicine. The practice and supervision of s is covered in SOP C09 Deployment and supervision of clinical practice of ACAs, ECAs, student paramedics and advanced technicians.. Persons authorised to administer under a PGD may not direct another person to administer on their behalf.