Guidelines for EMTs on adrenaline and diazepam

Yellow kit bag

Following some discussion amongst staff surrounding the use of 1:1000 adrenaline for emergency medical technicians (EMTs), it has become evident that some clarification regarding its use is required:

 Adrenaline 1:1000

The legislation

The Human Medicines Regulation 2012 (legislation relating to medicines law) sets out a comprehensive regime for the authorisation of medicinal products for human use. Regulation 238, schedule 19, outlines the use of adrenaline 1:1000 (up to 1mg for intramuscular use in anaphylaxis) by anybody for the purpose of saving life in an emergency.

What does this mean for us?

Emergency medical technicians (EMTs) should use adrenaline 1:1000, administered via intra muscular injection, in cases of anaphylaxis only. 


The legislation

  • Controlled Drugs Regulation 2013

Summary of legislation

Emergency medical technicians (EMTs) cannot possess and administer controlled drugs (all forms IV, IM, buccal and rectal) and we will be working on drug bag configuration to address this.

Emergency medical technicians (EMTs) cannot administer IV and IM controlled drugs.

Emergency medical technicians (EMTs) can administer prescription only medication (POM) controlled drugs prescribed to a patient and are not parenterally administration. Parenteral administration is defined as ‘breaching the skin or mucous membrane’. Nebulisation, buccal and rectal drug routes are not parenteral routes of administration.

What does this mean for us?

Emergency medical technicians (EMTs) can administer drugs such as buccal midazolam and rectal diazepam that have been prescribed to the patient (and are in the patient’s possession) with an accompanying clear patient care plan, including dosages.

Emergency medical technicians (EMTs) cannot administer non-prescribed controlled drugs of any form to a patient (i.e. none that we carry in our drugs bag).

Emergency medical technicians (EMTs) cannot take a verbal advice for administration controlled drugs from Trust drug bags.

Paramedics are exempt from the above regulations and should continue to administer diazepam/diazemuls (IV/rectal) as per current JRCALC guidelines.

If you have any doubts about whether it is appropriate to administer a drug, please call the clinical advice line – 07753 950843.

Published 21st July, 2016

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