Introduction

• The emergency equipment consists of a trolley, containing disposable items, equipment and drugs. Each clinical room also has an anaphylaxis pack. This is complemented with an 🔍Emergency Quick Reference Handbook for use in emergencies.
• Site paramedics are responsible for daily and monthly checks, and the lead paramedic has oversight. Each section details delegation if the site paramedic is not available.
• Trolleys should never be locked - each drawer is closed with a tamper-evident seal
• Staff should not be treated at their workplace, unless it is an emergency. Staff should never use the drugs from the trolley for minor ailments.
• For home visits, clinicians should take PPE, a pocket mask, and if they are administering any medication or vaccination, an anaphylaxis pack.

Daily checks

A quick check should be done daily to ensure tamper seals have not been broken, ensure the AED self-check light is flashing or showing a tick, and ensure the oxygen cylinder is full. The check must be recorded on the daily log.

In the event of a broken, damaged, or VOID seal:

• A full inventory should take place by Site Paramedic (or the Lead will appoint a suitable member of staff)
• Confirm this as an additional entry on the Monthly checks log
• Report to Site GP Lead & Paramedic Lead
• Confirm if something happened warranting access to equipment or medication, and if so a Significant Event Form has been submitted
• If nothing has happened warranting access, submit a Significant Event Form and report the discrepancy to the GP Lead & Paramedic Lead

Monthly checks

• Site paramedics will be scheduled for sufficient time during their normal day
• The check includes a full inventory of all emergency equipment & medication, and ordering replacement stock, consumables and medication. You must also check each anaphylaxis pack.
• Medications must exceed the minimum quantity. If not, you must order a new supply, and if a different batch number & expiry date delivered, you must dispose of the previous stock.
• The trolley should then have it’s seals replaced
• Each of the clinic room’s anaphylaxis packs should be checked, and resealed
• The site’s home visit bag should be checked
• The check must be recorded on the monthly log

Items going out of date

• When an item is going out date, either due to finding it during a full check or an email notification, begin the order process (See below)
• Email notifications will continue
• When the replacement item arrives, dispose of the previous item, and place the new item in the trolley. You must update the Microsoft Teams list.
• This will stop the email notifications
• If an item expires before the replacement arrives, it must be disposed of. You will be unable to update the teams list until the new item arrives.
• The email notifications will continue, until the list is updated

Ordering

Oxygen

• If there is a fault with an oxygen cylinder, or it is empty, inform the Site GP Lead and Paramedic Lead
• If the GP Lead is unavailable, both on-call GPs for that day should be informed
• To request oxygen replacement, call BOC directly using the number on the side of cylinder (most suggest 0800 111 333)
• This should be done before 14:00 to ensure next working day replacement

Medication

1. Complete Medication Order Form (See below) specifying required medication & quantity. At the start of the notes section at the end of log row, write ‘Ordered: 22/08/23’
2. Obtain signature from Site GP Lead, and in their absence from the on-call GP
3. Scan a copy, and upload to the shared drive
4. Before sending to the pharmacy, email the Lead Paramedic for review

Once approved:

1. Hand the signed hard copy to the preferred local pharmacy
2. Some pharmacies deliver to the practice, whilst others require a collection. Speak to your reception manager or Lead Paramedic if you
3. Once received, the site paramedic should update the inventory. Ensure dates are written dd/mm/yyyy. At the start of the notes section at the end of log row, write ‘RCVD: 24/08/23’.

Consumables

Work with your HCA to determine how they would like to receive your consumable requests

Most items on 🚨List of Emergency Drugs & Equipment have AVSS order codes or are surgery stock.

1. For AVSS items, Send requests to site HCA
2. Once received, the site paramedic should update the inventory

For surgery stock, select the items from surgery storage areas. This should be updated on the emergency trolley inventory, but there is no recording for surgery stock areas.

Equipment

1. For anything not specified on the form, email the paramedic lead specifying what is needed, and the reason for request
2. The paramedic lead will manage the request, and arrange in appropriate
3. Once received, the site paramedic should update the inventory

Discarding of medication

Controlled Drugs (e.g. Midazolam)

Return these drugs like all other medications (see below), but hand them over separately to the pharmacist, as these need to be dealt with differently.

See also 🎛️Controlled Drugs

Other Medication

Once single-use medication has been opened, or medication that is out of date or not fit for use should be:

1. Removed from stock and inventory, by placing in a bag and marking ‘NOT FOR USE’
2. Add to the discarded medication form (including what the medication is, quantities, and reason)
3. Medication should be handed to a local pharmacy. The pharmacist or counter clerk will need to countersign the form. They may ask to make a copy.
4. Scan a copy, and upload to the shared drive

Forms & storage

All forms can be found on OneDrive - This is also the same place to upload completed forms