March 8, 2024

Welcome to UH EMS-I’s Pharmacy Phriday. In this week’s installment, we focus not on any specific medication but on an element of the system that provides our drug boxes and medications.

Have you ever noticed the tags on the outside of the box? A Mini-box? On the vials? On the packaging of the aerosols? On the packaging of the syringes? In actuality, the drug box and every item within the drug box should have a small tag attached, including any supplies. (See figures 1 & 2)

These tags are part of a system called Kit Check. Kit Check is an accountability system used in hospital settings for anesthesia trays, crash carts, etc. The system is also used by UH pharmacies for the drug boxes provided to our EMS squads. Some of the benefits realized with the use of this system include tracking of drug boxes, medications, and supplies that may be expired or expiring; tracking of recalled medications and supplies; and assisting in accurate restocking of medications and supplies used when a box is returned. The system also benefits the pharmacies in time and personnel savings.

When a box is returned for restocking, pharmacy staff can place the box within a scanner (they like to call it the “microwave”), which searches for the RFID tags mentioned above (See figure 2). Based on the scan, the system advises which medications or supplies are missing and in need of restocking. The system can also advise pharmacy staff of any expired medications. Once restocked, the box is scanned again to be sure all necessary items are included in the box, and the information is saved within the inventory tracking program. This information can be used to recall a box for out-of-date or recalled medications or supplies in the future.

Some problems that can occur with the use of the system include:

• Stickers can sometimes fall off the packaging of a medication or supply and fall to the bottom of a tray or the box. When this occurs, the scanner recognizes the tag, and the item is not indicated for restocking or resupply. Anytime a tag is found in a drug box that is not attached to a supply or medication, the box should be returned with an explanation of the problem so that pharmacy staff can address the labeling issue.

• Any empty medication vials, syringes, or packaging that is placed back in a drug box after use can also lead to errors in the system. The scanners do not recognize whether a vial or package is full or empty, just that it is there, leading to restocking errors. To avoid such instances, providers must be sure to throw away used boxes, vials, wrappers, etc.

• Another problem that can occur involves partially used medication vials. When a medication has been administered but partial amounts remain in the vial, all unused portions should be disposed of or “wasted” according to policies. An example of this might include the mixing of Ketamine as a pain medication. Any mixed medicine not administered should be wasted by the provider, as well as any remaining medication within the vial.

To further understand the Kit Check system, click here to view a YouTube video demonstrating its use.

Our cooperation in remembering and following the above-mentioned points can greatly affect the efficiency of the use of the Kit Check system and improve our ability to maintain supplies and care for our patients effectively in the field. Thanks for your support in these efforts.

Till the next installment, stay safe!

Sincerely,



The UH EMS-I Team

University Hospitals