Office of Emergency Medical Services
Department of Public Health
Commonwealth of Massachusetts
Process for ALS-Paramedic level Licensed Ambulance Services Opting to Carry and Use Ketamine in Accordance with the Statewide Treatment Protocols
Please find attached a memo from Bureau of Health Professions Licensure Director James Lavery, and Bureau of Health Care Safety and Quality Director Eric Sheehan, regarding the implementation process for ALS-Paramedic licensed ambulance services to obtain an Massachusetts Control Substances Registration (MCSR) to be able to carry and use Ketamine, if they choose to do so in accordance with the Statewide Treatment Protocols. Attached also is the application for an MCSR to carry Ketamine, a Schedule III medication not covered by the previous ambulance service MCSRs.
Some important notes:
- If your service already has a current MCSR, and you wish only to add approval to carry and use Ketamine, there is NO FEE. Please complete the application, check the appropriate box (NEW- KETAMINE-ONLY MCSR), and send it in with the required affiliation agreement and drug security policies, but without any check.
- If your service needs to renew its MCSR at this time, and in addition, wish to add Ketamine, please check BOTH boxes, NEW- KETAMINE-ONLY MCSR and RENEWAL) include a check for the $300 fee, and send it in with the required affiliation agreement and drug security policies.
- Address the special security measures for Ketamine: Please note that Ketamine must be kept in a separate, clear acrylic container, with numbered seals used as locking devices. The container shall then be stored within a locked bag/box/cabinet. This needs to be a separate container from the regular narcotics box. The locking device may be a plastic numbered seal, combination lock or key lock. The ambulance door or ambulance garage will not be considered as one of the locking devices. In your MCSR application, you will need to describe the manner in which Ketamine will be secured in compliance with this requirement. Your department or service’s drug security policies should also be updated to describe your Ketamine compliance processes.
- The Drug Control Program (DCP) reports that MCSR review and processing times may vary. This process can take up to six weeks. Until an ambulance service has the MCSR for Ketamine, it cannot carry this medication.