Training for Pharmacists for the Supply and Administration of Emergency Medicines

Pharmacists who have completed the required training, are permitted to administer five medicines for the purpose of saving life or reducing severe distress in certain emergency situations:

• anaphylaxis (adrenaline),
• asthma attack (salbutamol inhaler),
• hypoglycaemia (glucagon injection),
• angina attack (glyceryl trinitrate aerosol),
• opioid overdose (naloxone).

Read the legislation which allows for these services.

How can I complete training?

You can find more information about training and providers on the Irish Institute of Pharmacy (IIOP) website. You will find details on how to register and complete most of the required training programmes. Many of the training programmes are available online as e-learning programmes, and are free of charge. There is a fee associated with the Medicines Administration (Parenteral) (PAMT) training programme which is a blended programme, involving both online and face to face components.

What training do I need to complete?

The training programmes you need to complete will depend on what services you wish to provide. A diagram of the training programmes is set out below. This is known as a ‘modular’ system of training. Some of the training programmes are the same as those required to supply and administer vaccinations. If you have competed training in these programmes previously and still have a valid certificate for this training, you do not have to complete the training again. Further information on vaccination services training requirements is available. 

The training programmes for the specific vaccines you wish to administer can then be completed. This is illustrated in the diagram below.

Diagram illustrating pharmacist training requirements for the supply and administration of vaccines and emergency medicines

View a PDF version of this diagram.

*The National Immunisation Advisory Committee (NIAC) made significant changes to the Anaphylaxis Chapter of the Immunisation Guidelines for Ireland in June 2022, which stated that “Adrenaline auto-injectors are not recommended as first line treatment by health professionals for the immediate management of anaphylaxis or suspected anaphylaxis following vaccination unless they are the only source of adrenaline available, as they may not allow IM delivery of an age appropriate dose”.

In the absence of any other National Guidelines for the immediate management of anaphylaxis in the community, PSI would consider it best practice for a pharmacist to administer Adrenaline (Epinephrine) intramuscularly from an ampoule, in all emergency circumstances (where indicated), in accordance with NIAC guidelines.

  

This would require the pharmacist to have valid training in:

• CPR,
• RESMA, and
• PAMT

However, if only an Adrenaline (Epinephrine) auto-injector is available, or if you are only trained and competent to administer an Adrenaline (Epinephrine) auto-injector, this should be used.

Pharmacists should use their expert knowledge, skills and professional judgement to administer Adrenaline (Epinephrine) in line with national guidance in accordance with the product readily available to them, which they are trained and competent to administer.

How can I access training and how long is it valid for?

Training programme	Validity period
CPR Course for adults and children	Details of providers are available on the IIOP website. Training is valid for two years (or as stated by training provider)
Medicines Administration (Parenteral) (PAMT) training programme	Available as a blended programme through Hibernian Healthcare. Pharmacists are asked to reflect, self-assess and to evaluate whether they need to refresh their training in this programme, in order to ensure they have the necessary skills and knowledge to safely deliver the associated medicines or vaccination service. The PSI requires that this training programme is repeated if a pharmacist wishes to administer: 1. a vaccine or emergency medicine via an injection route i.e., intramuscular or subcutaneous, which they have never previously administered; or 2. a vaccine or emergency medicine via an injection route which they have neither practised (i.e. administered to a patient) nor been trained on in the previous 12 months (or in the case of seasonal influenza vaccination, in the previous flu season)
Responding to an Emergency Situation and Management of Anaphylaxis (RESMA) training programme	Developed by Hibernian Healthcare and available through the IIOP. Training is valid for two years.
Delivery of a Pharmacy-based Vaccination Service Training Programme	Available through the IIOP. Pharmacists are asked to reflect, self-assess and to evaluate whether they need to refresh their training in this programme, in order to ensure they have the necessary skills and knowledge to safely deliver a vaccination service. The PSI requires that this training programme is repeated if a pharmacist has not vaccinated in the past 12 months (or influenza season).
Training for the specific vaccine(s) to be administered	Available either through the IIOP (influenza, pneumococcal and herpes zoster (shingles) vaccines), or in the case of the COVID-19 vaccines, through HSeLanD. Influenza training is valid for one year. Pneumococcal and Herpes Zoster training is valid for two years.
Emergency Medicines
Glyceryl Trinitrate Spray	Two years
Salbutamol inhaler	Two years
Glucagon	Two years
Naloxone	Two years

In addition to completing the above training pathway, pharmacists should ensure that they are familiar with the most recent versions of both the NIAC and NIO national guidance documents on management of anaphylaxis. Pharmacists should be aware of updates to relevant national guidance and adapt their practices to reflect the most up to date information.

What do I need to do each year?

You should review the training requirements for the delivery of the service(s) you wish to provide each year. You should check that your training in each training programme is up-to-date. You should also complete a self-assessment and self-declaration form, which will help you to review the requirements and provide a means for you to attest to your competency to deliver the chosen service(s).

If you have any questions about the training requirements, you can email cpd@psi.ie

Useful resources

• National Immunisation Advisory Committee (NIAC) Immunisation Guidelines for Ireland
• Anaphylaxis Chapter Immunisation Guidelines for Ireland