Month: January 8,
ED Departmental Policy
Policy # 8.43
Title: Medications in the Emergency
Department: Managing STAT and
To standardize the process for communicating and handling STAT and urgent
medication orders to assure the best possible outcome for the patient.
To outline roles and responsibilities to assure a consistent response from all disciplines
when medications are needed in critical and urgent situations.
A. “ STAT medication”:
1. A medication with a rapid onset of action that is needed for a potentially life
threatening or emergency situation, or when a patient is experiencing acute
pain, agitation or severe discomfort.
2. Refer to UWHC Administrative Policy 7.08 Management of STAT
Medications for Inpatient Units for an expanded definition of STAT
B. “ Urgent medication”: A medication when delay in administration prevents the patient
from leaving the emergency department either to discharge or to transfer to another
C. Turn around time: The amount of time required from order entry or verbal
communication of the order to medication administration.
A. The ordering provider enters a STAT or urgent medication into the electronic medical
record, and alerts the registered nurse (RN) or pharmacist with verbal confirmation that
the message was received.
B. Upon learning of the STAT or urgent medication order, the RN checks the floor stock
medication for availability.
C. If procured from central pharmacy, the RN must verbally confirm that the pharmacist is
aware of the STAT or urgent medication order.
1. If the ED pharmacist is on duty,
a. Contact the pharmacist and confirm the pharmacist is able to verify the
b. If the pharmacist is involved in another urgent situation and/or is away
from the ED, the RN will calll the central pharmacist
2. If the ED pharmacist is not on duty
a. Call the central pharmacist
D. The RN will be responsible for retrieving the medication from the pneumatic tube
station and documenting administration of the medication in the electronic medical
1. STAT medication turn around time is less than 30 minutes with the
expectation that medications will be procured and administered to the patients
as soon as safely possible.
2. Assigning the status of “ STAT” to a medication is intended to assure the
responsiveness of the system when these medications are needed.
3. Effective and frequent communication between providers (RN, MD,
Pharmacist) is essential in situations when STAT and urgent medications are
4. All medication orders, excluding Code Blue events, must be entered into the
electronic medical record and include documentation of administration.
5. In emergency situations, healthcare providers should optimize medication
administration response time by using medications available in crash carts and
automated dispensing cabinets as these medications are readily available in the
IV. UWHC CROSS REFERENCE
A. UWHC Administrative Policy 7.08 Management of STAT Medications for Inpatient
B. UWHC Administrative Policy 8.16 Patient Care Orders
V. REVIEWED BY
ED Clinical Nurse Specialist
ED Clinical Operations Committee
Inpatient Pharmacy Managers Committee
Service Chief, Emergency Medicine
Pothof, Jeff Denise Cole-Ouzounian
Vice Chair of Quality and Operations Nurse Manager
Emergency Medicine Emergency Department