How is everyone handling medications that come from procedure trays/kits (e.g. epidural, central line, spinal, etc.) These typically contain lidocaine, or other anesthetic drug. These kits are provided by 3rd party vendors and bypass pharmacy oversight. How is frontline staff directed on what to do with the unused medications? For pharmacies that collect them, do you recirculate/redispense the medications?

Any sites have pain/sedation kits for trauma cases coming into the ER? Recently we had a very difficult to sedate and delays obtaining the medications for a trauma patient. The ER and trauma surgeon are requesting a kit containing pain and sedation medications for urgent/emergent use, like the RSI kits. Example medications requested are fentanyl, midazolam and ketamine. 

I saw this last posted in 2014, but wanted to re-address given the heightened focus on NMBs. To comply with the ISMP recommendations of segregating NMBs in an RSI kit in patient care areas, we have standardized our RSI kits in the ICU and ED. We store them in the refrigerator both in the pharmacy and patient care area Pyxis'. These kits go in and out of the fridge and what I am wondering from this group is: