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Emergency Use Drug Shortage Could Put Patients At Risk

PITTSBURGH (KDKA) - If you need an ambulance, it usually means you need emergency care and more often than not, the care you receive in the ambulance makes all the difference.

However, paramedics and EMTs are facing a drug shortage that's making their job more difficult.

If you needed certain medications urgently, would they be there for you?

For the past 18 months, there's been a shortage of several emergency use drugs. These include the narcotic pain reliever morphine, a medication for seizures, Valium, a drug for severe nausea, Zofran, and the narcotic reverser, Narcan.

Because of the shortage, the paramedics are forced to use a hodgepodge of supplies.

That can slow them down when time can be of the essence.

"If you notice, whenever I opened up in the medic unit, there [were] three different types of packaging in there. We're used to one single dose, pre-filled syringe. But, there was a single-dose vial, there was an ampule, and there was one pre-filled syringe," Scottie Garing from West View EMS said. "Information's found on different parts of labels, in different locations, written smaller, written larger."

Also, patients have to be just right for the medicines on hand.

"In the case of Zofran, for example, if someone is mildly nauseated, they may withhold that Zofran for the person who is severely nauseated, or actually vomiting," Garing said.

In some cases, substitutions are made.

"There's been a handful of seizure patients that we would have liked to have given Valium to who got Versed or Midazolam in its place," Greg Porter from West View EMS said.

Alternatives in the same drug family are approved by the state. But, sometimes they aren't exactly the same.

"So, with heart attack, the standard drug is morphine, for the reasons of making the heart work less hard, but if there was no morphine, we had to use fentanyl," EMS Medical Director Dr. Paul Paris said.

Fentanyl doesn't have the same effects on the heart. In some cases, there's nothing similar to give in its place.

"Narcan, which reverses opiate overdose. there is no other drug on the state formulary that would do that when someone has had too much of an opiate," Dr. Paris said.

These drugs are not under patent and they aren't expensive. So, why is there a shortage?

"Because it's not expensive. There's not a great profit margin," Dr. Paris said.

In cases where there is not a good substitute, Dr. Paris said there has been regional sharing. A rescue squad with no supplies may get some from another station in the area that might be better stocked.

How and when the shortage will end, no one knows. But, they all agree that more reliable sources for medications need to be in place.


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