Monthly Controlled Substance Inventory Log

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Silver Cross EMS System Monthly Controlled Substance Inventory Log
Agency:
CS REQUIRED on ALS Ambulances: Morphine 20mg, Versed 20mg, Fentanyl 200mcg, Ketamine 500mg
Unit:
CS REQUIRED on ALS Non-Transports: Morphine 10mg, Versed 10mg, Fentanyl 100mcg, Ketamine 0
Month/Year:
Day Tag #
MORPHINE
VERSED/MIDAZOLAM
FENTANYL
KETAMINE
Signature(s)
SCEMSS
mg Exp Lot #
mg Exp Lot #
mcg Exp Lot #
mg Exp Lot #
System #
1
2
3
4
5
6
7
8
9
10
Attachment: Policy 300-37e

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