Tracking and Controlling Access to Controlled Substances
Clark County is the largest fire department in Nevada, providing emergency services to an area encompassing 7,910 square miles that includes the Las Vegas Strip, a large portion of the Las Vegas Valley and neighboring resort townships. The department also maintains one of the nation's Urban Search and Rescue Teams. This extremely busy fire department's 29 paid fire stations and 13 volunteer fire stations responded to 122,111 incidents in 2008.
Clark County Fire Department acts as the first responder. Personnel stabilize the injured so they can be transported to the hospital by private ambulance. The private ambulance companies are under contract with Clark County and the cities of Las Vegas and North Las Vegas. Clark County FD has 25 rescue vehicles and 27 engine companies that respond at the Advanced Life Support (ALS) level. They run dual-response on all medical calls to ensure that there are two paramedics per patient at the scene: one from the fire department and one from a private ambulance company.
Jeff Reagor, Clark County Fire Department EMS Supervisor, says, "We were required to have a system of checks and balances in place that would provide an accounting of the handling of all controlled substances. Our narcotics needed to be safely secured in each of our ALS engines and rescue vehicles."
Reagor explains, "In order to run EMS calls in Clark County, all fire departments and private ambulance companies are mandated by the Southern Nevada Health District to have the oversight of an independent Medical Director and a QA Director. Dr. Dale Carrison, Chief of Staff at the University Medical Hospital, oversees the medical direction of Clark County F.D. Our QA Director, Jo Ellen Hannom, RN, works closely with him in the regulation and management of all our controlled substances. Our controlled substances are obtained under Dr. Carrison's license so it's imperative we provide accountability for the drugs we use. Clark County FD needed a system that would allow them to know when their narcotic safes were being accessed and by whom."
After researching available products, Reagor shares the department's reasons for choosing CyberLock, "With CyberLock, we could gain tight key control and the ability to track how many times and when our narcotic safes were being opened. We saw this as a good way to have accountability with our narcotics handling."
Reagor continues, "Deputy Chief Russ Cameron, Chief of the department's Fire and EMS Training Program, obtained the funding for the CyberLock system and, in May 2008, we began installing CyberLocks on our narcotic safes. We worked closely with A&B Security, a Las Vegas access control and security company. A&B Security is the department's supplier of narcotic safes. Their people came on site and gave us the support we required to install and manage the CyberLock system."
Each time the Clark County FD gets a new rescue unit, mechanics install a narcotic safe onboard. The safe is secured in the unit with titanium hardware and fitted with a CyberLock in a matter of minutes. The unit number, a unit identifier and the fire station it is assigned to are entered into the CyberLock system software before delivering the rescue unit to the appropriate fire station. Extra electronic keys are stored in a secured centralized location so a key can be activated whenever the department receives a new rescue unit.
To date, Clark County has installed CyberLocks on safes in the fire stations themselves, on rescue unit safes and on safes in engine company vehicles. The department also has a reserve fleet that consists of five rescue vehicles, eight engines and two ladder trucks. Each of these is equipped with a narcotic safe that has been fitted with a CyberLock.
Reagor comments, "In the event we need to use one of the reserve fleet vehicles, the CyberLock software allows us to quickly program an electronic key on-the-fly to access that particular unit's safe."
When a rescue vehicle is taken out of service, involved in an accident, or disabled in some manner, the narcotics are immediately removed from that unit's safe and placed in the fire station safe until the department receives a replacement rescue unit.
Imad Bachir, the department's Systems Specialist, was instrumental in interfacing the CyberLock software with Clark County's computer network. The integration of the two systems went smoothly and they work together seamlessly. The CyberLock software runs on each fire station's office computer.
Reagor states, "The electronic locks and keys record openings and unauthorized attempts to enter, so at any time an EMS supervisor can pull up a log of events in the software and see when a narcotic safe has been opened and by whom. The audit report the CyberLock software provides is of utmost importance to us."
EMS Coordinator Troy Tuke oversees all Clark County's EMS operations including the audit process for the department's controlled substances. Each EMS supervisor is responsible for managing the CyberLock System for their assigned platoon. One key is issued for each rescue unit that has a paramedic onboard, and one individual is assigned responsibility for that key. The EMS supervisor can look at the audit report from the safe lock and the key to see if that responsible individual is checking drug expiration dates, taking inventory of the drugs, and insuring that the drugs have not been tampered with. This must be done during shift-changes in the morning of each day. If the EMS supervisor sees that a safe has been opened any other time of the day, it must correspond with an emergency call during that time. If there is a discrepancy, the EMS supervisor would immediately report this to the EMS Coordinator for further action.
If an electronic key is lost, the EMS supervisor can go into the system and deactivate the key so it will no longer open that particular narcotic safe. A new key can then be assigned to that rescue unit. If someone tries to open a safe that their key is not authorized to access, the safe's lock will not open and their key will alarm. Also, there will be a record of that person's key being denied entry to that safe.
Reagor says, "If a safe should be opened at a time there is no emergency call, it would raise a red flag and have to be investigated. We would know who has possession of the key."
The CyberLock software generates a monthly report of narcotic safe and electronic key activity from all department units. If a certain individual is not compliant, the department takes aggressive steps to make sure they do conform by checking the drugs they are responsible for.
Reagor comments, "Our QA Director and Medical Director have been extremely pleased with the CyberLock system because it has reinforced accountability and the detailed information it provides is invaluable."
Reagor summarizes, "We are always looking for effective solutions that allow us to expand and improve our services to the people who live in or visit our communities. Implementing CyberLock to more efficiently manage the handling of our controlled substances has been a great decision for us. As the Las Vegas area grows and the need for services and protection increases, Clark County Fire Department is poised to meet those needs."
Andy Hilverda is Vice President of Videx, Inc., a company that designs and manufactures CyberLock access control products that are shipped worldwide from their headquarters located in Corvallis, Oregon. Hilverda can be reached at 541/758-0521 and firstname.lastname@example.org. For more information, visit www.videx.com.