Date November 10, 2011 (FINAL) Authors Karen E. Jacobson – NEMSIS Director Keith R. Davis – NEMSIS Data Architect N. Clay Mann – NEMSIS P.I. dConfiguration.04 - Medications Permitted by the State The code list associated with dConfiguration.04 (Medications Permitted by the State) is represented by a selected group of values found in RxNorm. RxNorm is a standardized nomenclature for clinical drugs and drug delivery devices. The process for gaining access to the RxNorm code values is provided at the end of this document. RxNorm Code Usage Recommendations RxNorm provides various codes for medications based on the Term Type (TTY). These include but are not limited to: Ingredient (IN), Precise Ingredient (PIN), Brand Name (BN), Semantic Clinical Drug Form (SCDF), Semantic Clinical Drug Component (SCDC), codes indicating the medication strength or concentration or mixtures (Synonym of Another TTY = SY), and many term type dosing options.
The NEMSIS TAC recommends that medications administered by EMS professionals in the pre-hospital setting be recorded and submitted using the Ingredient (IN) code for the large majority of medication names. This is frequently the generic name of the medication. The NEMSIS Version 3 dataset has elements that al ow for the separate documentation of the medication route, dosage, and dosage unit using the fol owing three elements:
1. eMedications.04 - Medication Administered Route 2. eMedications.05 - Medication Dosage 3. eMedications.06 - Medication Dosage Units
To review the RxNorm overview, including an introduction, purpose and examples of RxNorm, and its usage please visit To see the explanation of the term types see page five (5) of this document.
Suggested List for dConfiguration.04 - Medications Permitted by the State The suggested medication description and RxNorm (RxCUI) Code list is designed for the pre-hospital setting. The medication list was developed based upon collaboration between the NEMSIS TAC and EMS Medical Directors at the agency and state level.
Please note the medications are provided based on the Term Type (TTY) and its corresponding RxNorm description (unless otherwise indicated via italics). There are 114 medications and five (5) parenteral solutions included in the lists below.
The collaborators recommend the use of “Dextrose” for parenteral administration and “Glucose” for oral administration of sugar based medications/solutions. RxNorm Medications for EMS in the pre-hospital environment Medication Medication
-- To be used for parenteral administration.
-- To cover one aspect of blood products.
-- To be used for topical use administration.
Chitosan -- Topical Hemostatic Agent - Chitosan based
D10 (dextrose 10 % Injectable Solution)
D25 (dextrose 250 MG/ML Injectable Solution) SY
D50 (dextrose 50 % Injectable Solution)
-- To be used for irrigation: burns, eyes, etc.
Medication Medication
Epinephrine 0.1mg/ml (Epi 1:10,000)
Epinephrine 1 mg/ml (Epi 1:1,000)
Glucose (any oral form or by mouth) RxNorm Parenteral Solutions for EMS in the pre-hospital environment Parenteral Solutions Name TTY Code Parenteral Solutions Name
Sodium Chloride 3% Injectable Solution SY
Sodium Chloride 0.45% Injectable Solution SY
Sodium Chloride 0.9% Injectable Solution
Licensed “Suggested Lists” The U.S. National Library of Medicine provides access to the RxNorm code values through the Unified Medical Language System (UMLS). An applicant must accept the terms of the UMLS Metathesaurus License and create a UMLS Terminology Services (UTS) account for access to UMLS datasets and terminology browsers.
More information can be found at:RxNorm codes may also be accessed through
The NEMSIS TAC may only distribute suggested lists with specific value codes from the UMLS system to entities licensed through the UMLS system. Thus, each software developer must seek licensing and provide proof of licensing before gaining access to all of the pre-defined suggested lists available through the NEMSIS TAC.
Access to “Suggested List” Archive Files Access to suggested code lists wil be provided on a special section of the NEMSIS TAC’s SharePoint site. A licensed user will be able to login to the SharePoint site and download the appropriate archive file (RxNorm, ICD-10, etc).
The UMLS license verification service helps determine if the remote user has a license to use and/or distribute certain code sets. If the user does not have a current license, access to the “suggested lists” archive will be denied.
The “suggested list” files wil be zipped archives that are automatical y created each time one of the licensed code databases is updated in the NEMSIS master data repository.
Viewing and Using the “Suggested List” Archive Files The downloaded suggested list appears in a pipe-delimited text format. The proper code to utilize for medications is the “RxNormCode”. Please note that the RXCUI, RXAUI and TTY fields are included for reference purposes. These codes al ow one to locate the exact code and description in the UML S Metathesaurus that was selected for inclusion in the suggested list.
The list provides additional fields indicating when a record became active in the NEMSIS TAC’s master data repository as well as the version of the source used for a particular code and description in a suggested list.
Conclusions By maintaining a single source of these data and making it available internally as well as to our customers, we improve our data quality and consistency. This will reduce reporting errors in data submissions provided it is used as part of our own and our customer’s data management best practices. RxNorm Medication Term Types (TTY) From the National Library of Medicine website:.
Las inversiones realizadas en el territorio de una Parte Contratante por cualquier entidad jurídica de esa misma Parte Contratante pero que sea propiedad o esté contro-lada efectivamente por inversores de la otra Parte Contra-tante se considerarán también inversiones realizadas por inversores de la segunda Parte Contratante, siempre que se hayan efectuado de conformidad con las leyes y regl
Appendix 4.3 Special Special-Status Plants Known to Occur Within 10 Miles of the Downtown Specific Plan Area Asteraceae often seen along sloughs with common reed, tule, cattail and blackberry. Elevation 0-3 meters. Balsamorhiza macrolepis macrolepis [sometimes serpentinite]. Elevation of Cotatithis species expected from future development proposals. No CNDDB records within None.