Drugs and supplies for execution Montana prison

MONTANA STATE PRISON

ATTACHMENT A

Execution Equipment and Material Checklist: Execution by Injection

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Number ITEM CODE

6 Sodium Pentothal, 1 gm. kit, (50 mg/ml)* A

20 Pancuronium Bromide, 10 mg/5 ml vial* A

3 Diazepam (Valium), 2 ml Dosette syringe A

20 Syringe, 60 cc Lur Lock B

10 Syringe, 10 cc Lur Lock B

10 Syringe, 5 cc Lur Lock B

40 18 Ga., 1 ½” needles B

20 25 Ga., 1 ½” needles B

50 14 Ga., 1 ¼" angiocath B

50 16 Ga., 1 ¼" angiocath B

50 18 Ga., 1 ¼" angiocath B

8 Normal Saline, IV bag, 1000 cc B

8 Solution Injection set; 106” long with Y sites B

16 Extension set, 35” B

2 Stethoscopes B

3 Boxes of alcohol preps B

24 Rolls of Kling B

4 1” adhesive tape, B

4 2” adhesive tape, B

3 pr Bandage scissors B

12 IV start Kits (gauze, dressing, CloraPrep, tape, tourniquet) B

3 pr Surgical gloves size 7 ½, (sterile) B

3 pr Surgical gloves size 8 (sterile) B

1 Box Gloves, 100 Large (nonsterile) B

12 Surgical masks B

3 pr Hemostats B

6 3” ace wraps B

100 Gauze pads (sterile) B

1 Clean up kit B

1 Flashlight with batteries B

6 Batteries (flashlight spares) B

1 Tourniquet B

1 Large Sharps container B

2 Small Sharps container B

*Drugs listed may be substituted with another equivalent type drug

if drug listed becomes unavailable. Refer to TM 1/05.12 E4