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Medication Safety in Prehospital Settings – Safe Storage and Identification of Medications

Posted by Spencer Fullerton on 5/22/2012
Medication errors tend to be associated with hospitals but they can happen anywhere and especially in a fast paced prehospital environment. Many remember learning about medication safety in school but what about the 5R’s: Right patient, Right drug, Right dose, Right route and Right time? Many EMS agencies have added the sixth right being Right documentation. In the hospital setting medication errors occur during the prescribing, dispensing and administration of medications. Physicians, pharmacists and nurses are involved. In the prehospital setting, EMTs and paramedics perform the duties of these individuals. Someone is responsible for ensuring that each ambulance has the correct quantities of medications, that they are appropriately labeled, checking expiration dates and that they are in the correct location in the ambulance or kits before going on runs. If all of these checks do not happen an error can occur. Because of the fast paced prehospital environment it is highly open to medication errors. The setup of the drug box and organization of medications can play a vital role in eliminating medication errors. EMS needs to have the tools and systems in place to eliminate medication errors. Start by asking some of these questions and reviewing situations that may lead to a medication error. Are there look alike/sound alike drugs next to one another in your drug box? How are the look alike/sound alike drugs differentiated from one another? Are you identifying high alert medications in some manner to draw attention to them for double and triple checks? Are you using Broselow tape correctly and frequently? Do you identify medications where the dosage strength should be noted? Do you have prefilled syringes stored in the same compartment? How do you differentiate? Introduce systems in which vials and packaging with similar appearances are marked to avoid choosing the wrong one. Labeling, shrink bands, separate storage containers and bags are great tools to prevent medication mix-ups and to draw attention to the medications as well as verify strength and expirations etc. Don’t assume that because you deal with far fewer medications than the hospital setting that the errors are really hard to occur. The drug shortage crisis has opened opportunities for more errors to occur. Different strengths, manufacturers and packaging can lead to errors. The goal is to have systems in place so an error cannot occur. The goal is to help and never harm! E M Innovations provides a range of error prevention and medication safety items to help provide safe storage and promote safe use of medications. Visit our medication safety category at
Resources and Articles on Medication Errors in Prehospital Settings