Exchange of the kit in the emergency department must only be performed by a pharmacist, nurse, or prescriber if the kit contents include Schedule II, III, IV, or V drugs: 

Why can't ALS providers remove their own narcotics/medications from a pyxis system? What problem are we trying to solve here? What if the ED is staffed with Paramedics? Can they replace the scheduled medications? This will create more of a problem by requiring overworked nurses to complete one more unneeded step.