Emergencies can happen at the pharmacy. It’s important to have plans in place to be able to respond in an appropriate and efficient manner that supports the health and safety of everyone involved.
The recent ISMP Canada Safety Bulletin: Unauthorized Access to Methadone in a Community Pharmacy Contributes to Death highlighted an incident where an individual died after ingesting a large amount of methadone that had been inappropriately accessed in a community pharmacy.
Among the recommendations made by the Office of the Chief Coroner of Ontario following this death was the importance of having an emergency preparedness plan for situations that may occur in the pharmacy.
ELEMENTS TO CONSIDER IN AN EMERGENCY PREPAREDNESS PLAN
The following are situations that pharmacies may wish to include in their emergency preparedness plan. Note that this is not an exhaustive list; Designated Managers/pharmacy managers will need to consider unique characteristics of their pharmacy when preparing their plan. First aid training materials will also often provide a list of potential emergency situations where a response may be required.
- Recognizing and responding to a mental health crisis (see the Pharmacy Connection article “Suicide Risk Assessment and the Role of the Community Pharmacist” for additional resources)
- Recognizing and responding to an opioid overdose, including where to find naloxone and how to administer it (see the Opioid Practice Tool for more resources, including those for patients and families)
- Recognizing and responding to emergency medical situations, such as injuries, heart attacks and anaphylactic shock, including where to find supplies/treatments that may be needed (i.e. AED, epinephrine auto-injectors, first aid kit)
- Identifying information that may be needed for first responders (i.e. medical conditions, treatment provided, pharmacology of medication that may have been ingested)
- Responding to a robbery or break and enter (see the Pharmacy Connection article “Safety and Security for Pharmacies: Preventing Robberies“)
- Responding to natural disasters in the community (i.e. fires, floods), such as facilitating access to medical records and critical medications and collaborating with other healthcare providers/authorities
It is critical that all pharmacy staff are trained on emergency preparedness protocols upon commencement of work at the pharmacy and that the plan is readily available and accessible to all staff in the pharmacy.
An emergency preparedness plan can also be part of larger business continuity planning (see the Ontario Pharmacists Association Pharmacist’s Guide to Pandemic Planning for resources.) With the ongoing COVID-19 pandemic, pharmacy managers may also need to plan for key issues such as:
- Ensuring the most up to date public health guidelines are reflected in pharmacy processes/operations
- Reviewing ongoing information and updates from the College, government, and others
- Managing potential risks to pharmacy staff and patients (including drug shortages, lack of accessibility/availability of prescribers, occupational health and safety)
- Managing personal protective equipment supplies, usage and training
- Managing staff absences and any changes required to pharmacy operations (i.e. changes in hours of operation)
Emergency plans should be reviewed regularly and updated as necessary.
THE IMPORTANCE OF FIRST AID TRAINING
It is a requirement of the NAPRA Model Standards of Practice for Canadian Pharmacists for pharmacists who provide patient care to maintain valid certification in first aid and CPR, at a level equivalent to the St. John Ambulance or Canadian Red Cross Standard First Aid & CPR/AED Level C.
As a self-regulated health professional, it is the responsibility of the individual pharmacist to determine the applicability of this standard to the nature of patient care being provided in the context of one’s specific working environment. Pharmacists should apply professional judgment to make this determination with the best interest, benefit, and safety of the patient considered first and foremost.
While First Aid and CPR training is not a requirement of the NAPRA Models Standards of Practice for Canadian Pharmacy Technicians, pharmacy technicians are strongly encouraged to obtain and maintain this certification.
For more information about this requirement, please visit the College’s First Aid Requirements for Pharmacy Professionals webpage.