What emergency drugs should I have available?

Answered by Tracy Green

This is covered in the CQC Mythbuster number 4.

Practices should consider where a patient presenting with an emergency condition would be managed. They should make sure this place would be appropriate. Drugs in the practice to help manage medical emergencies should be held in safe and appropriate storage conditions. This list is based on current practice. It is modified from two Drugs and Therapeutics Bulletins in 2015, and stakeholder engagement with medical directors of several GP practices.

This is not intended to be either exhaustive or mandatory. The final decision needs to be taken in context so choices/omissions can be professionally justifiable, and risk assessed.

Recommended practice

Practices should ensure they have emergency medicines and equipment to keep patients safe.

Professional guidelines: NICE: Prescribing in dental practice (Medical emergencies in dental practice)

These should be available to manage common medical emergencies:

• adrenaline/epinephrine injection, adrenaline 1 in 1000, (adrenaline 1 mg/mL as acid tartrate), 1 mL amps
• aspirin dispersible tablets 300 mg
• glucagon injection, glucagon (as hydrochloride),  1 – unit vial (with solvent)
• glucose (for administration by mouth)
• glyceryl trinitrate spray
• A fast action onset benzodiazepine drug  oromucosal solution
• oxygen
• salbutamol aerosol inhalation, salbutamol 100 micrograms/metered inhalation.

Professional guidelines: Resuscitation Council UK quality standards for cardiopulmonary resuscitation and training

This is the minimum equipment recommended:

• adhesive defibrillator pads
• automated external defibrillator (AED)
• clear face masks for self-inflating bag (sizes 0,1,2,3,4)
• oropharyngeal airways sizes 0,1,2,3,4
• oxygen cylinder
• oxygen masks with reservoir
• oxygen tubing
• pocket mask with oxygen port
• portable suction, for example Yankauer
• protective equipment – gloves, aprons, eye protection
• razor
• scissors
• self-inflating bag with reservoir (adult)
• self-inflating bag with reservoir (child)
• if there are ampules in the medical emergency drugs kit, there must be adequate numbers of suitable needles and syringes.

Oxygen cylinders should be easily portable but also allow adequate flow rates, for example 15 litres per minute for up to 30 minutes or until an ambulance arrives, or the patient fully recovers. Consider what size of cylinder to use and whether you need a second one in case the first is at risk of running out.

Quality Assurance Process: At least every week, check:

• expiry dates for emergency medicines
• equipment and availability of oxygen.