Execution Chemicals Preparation and Administration

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IDAHO DEPARTMENT OF CORRECTION Execution Chemicals Preparation and Administration
A. Modifications to Protocols and Procedures
There must be no deviation from the procedures, protocols, and chemicals in this procedure without prior consent from the Director of IDOC. A member of the Administrative Team must monitor and ensure
compliance with protocols and procedures related to the preparation and administration of chemicals.
B. Execution Unit
There must be sufficient lighting and physical space in the Medical Team Room, the Execution Preparation Room, and the Execution Chamber to enable the Medical Team to function properly and to observe the condemned person. The Medical Team will monitor the condemned person during the execution process with the aid of a telescoping color camera as well as fixed cameras. The cameras will broadcast to the Medical Team Room on color monitors. The condemned person will be positioned on the gurney and in the Execution Chamber to enable the Medical Team Leader to view the condemned
person’s intravenous (IV) location and face during the administration of execution chemicals until completion of the execution.
C. Preparation of Chemicals and Syringes
At the appropriate time, the IMSI Warden will transfer custody of the chemicals to the Medical Team Leader. The Medical Team Leader will supervise all activities related to chemical preparation and syringe preparation.
The Medical Team Leader shall assign a Medical Team member to prepare a set of syringes for primary set A, backup set B, and backup set C. The assigned Medical Team member shall prepare and label a set of sterile syringes in a distinctive manner identifying the specific chemical contained in each syringe by (a) assigned number, (b) chemical name, (c) chemical amount, and (d) the designated color, as set forth in the chemical chart below. This information must be preprinted on a label, with two (2) labels affixed to each syringe to ensure a label remains visible.
After the Medical Team Members have prepared and labeled the three (3) sets of syringes as described above, the Medical Team Leader will place the three (3) complete sets of syringes in the color-coded and labeled syringe trays in the order in which the chemicals are to be administered. The syringes will be placed in the color-coded and labeled syringe trays in a manner to ensure there is no crowding, with each syringe resting in its corresponding place in the shadow box which is labeled with the name of the
chemical, color, chemical amount, and the designated syringe number. The syringes must be placed in such a manner to ensure the syringe labels are clearly visible.
After all syringes are prepared and placed in the color-coded and labeled syringe trays in proper order,
the Medical Team Leader must confirm that all syringes are properly labeled and placed in the color-coded and labeled syringe trays in the order in which the chemicals are to be administered as designated by the applicable chemical chart.
After intravenous (IV) access is established via primary and backup peripheral catheters or a central venous line catheter, the Medical Team Leader will supervise the Medical Team Member assigned to draw chemical set A. The assigned Medical Team Member will draw the chemical into the properly labeled syringe as designated by the applicable chemical chart. After drawing each syringe, the properly labeled syringe will be placed back in the color-coded and labeled syringe tray in the order in which the chemicals are to be administered as designated by the applicable chemical chart. If backup chemical set B or backup chemical set C become necessary as described further herein, the assigned Medical Team Member will draw the chemicals for those sets in a similar manner.
Primary chemical set A will be drawn after (IV) access is established and before the execution process commences. The chemicals for back up chemical set B and/or C must be present and readily available to the Medical Team. Back up chemicals will only be drawn if deemed necessary by the Medical Team
Leader.
After the assigned Medical Team Member draws primary set A, the Medical Team Leader will notify the IMSI Warden that the Medical Team is ready to proceed with the execution.
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Note: All of the open or drawn chemicals must be used or properly disposed of no later than 24 hours after the time designated for the execution to occur.
Note: Should a stay delay the execution beyond 24 hours of the scheduled execution, another primary set of syringes must be prepared when the execution is rescheduled in accordance with the process set forth in this procedure. The replacement primary set of syringes will then be drawn in
accordance with the process set forth in this procedure.
D. Approved Chemicals
The IDOC has four (4) options for lethal injection methods. The option used is dependent upon the availability of execution chemicals.
The Director of IDOC has approved the following lethal injection chemicals and methods as described in Chemical Chart 1, Chemical Chart 2, Chemical Chart 3, and Chemical Chart 4:
Method 1
CHEMICAL CHART 1 CHEMICAL CHART 1
Backup Set B Backup Set C Syringe No. Label Syringe No. Label
1B (complete 1-4) 1.25 g Sodium Pentothal, GREEN 1C (complete 1-4) 1.25 g Sodium Pentothal, GREEN
2B (complete 1-4) 1.25 g Sodium Pentothal, GREEN 2C (complete 1-4) 1.25 g Sodium Pentothal, GREEN
3B (complete 1-4) 1.25 g Sodium Pentothal, GREEN 3C (complete 1-4) 1.25 g Sodium Pentothal, GREEN
4B (complete 1-4) 1.25 g Sodium Pentothal, GREEN 4C (complete 1-4) 1.25 g Sodium Pentothal, GREEN
5B (flush) 60mL Saline, BLACK 5C (flush) 60mL Saline, BLACK
6B (complete 6-7) 60mg Pancuronium Bromide, BLUE 6C (complete 6-7) 60mg Pancuronium Bromide, BLUE 7B (complete 6-7) 60mg Pancuronium Bromide, BLUE 7C (complete 6-7) 60mg Pancuronium Bromide, BLUE 8B (flush) 60mL Saline, BLACK 8C (flush) 60mL Saline, BLACK 9B (complete 9-10) 120mEq Potassium Chloride, RED 9C (complete 9-10) 120mEq Potassium Chloride, RED
10B (complete 9-10 120mEq Potassium Chloride, RED 10C (complete 9-10) 120mEq Potassium Chloride, RED
11B (flush) 60mL Saline, BLACK 11C (flush) 60mL Saline, BLACK
Syringe Preparation (Method 1)
Syringes 1A, 2A, 3A, 4A, 1B, 2B, 3B, 4B, 1C, 2C, 3C and 4C each contain 1.25 gm/50ml. of sodium pentothal / 1 in 50 ml. of sterile water in four (4) 60 ml. syringes for a total dose of 5 grams of sodium pentothal in each set. Each syringe containing sodium pentothal will have a GREEN label which contains the name of chemical, chemical amount, and the designated syringe number.
Syringes 5A, 8A, 11A, 5B, 8B, 11B, 5C, 8C and 11C each contain 60 ml. of a saline solution and will have a BLACK label which contains the name of the chemical, chemical amount, and the designated syringe number.
Syringes 6A, 7A, 6B, 7B, 6C and 7C each contain 60 mg of pancuronium bromide for a total of 120 mg of pancuronium bromide in each set. Each syringe containing pancuronium bromide will have a BLUE label which contains the name of the chemical, chemical amount, and the designated syringe
number.
CHEMICAL CHART 1 Primary SET A Syringe No. Label
1A (complete 1-4) 1.25 g Sodium Pentothal, GREEN
2A (complete 1-4) 1.25 g Sodium Pentothal, GREEN
3A (complete 1-4) 1.25 g Sodium Pentothal, GREEN
4A (complete 1-4) 1.25 g Sodium Pentothal, GREEN 5A (flush) 60mL Saline, BLACK 6A (complete 6-7) 60mg Pancuronium Bromide, BLUE 7A (complete 6-7) 60mg Pancuronium Bromide, BLUE
8A (flush) 60mL Saline, BLACK
9A (complete 9-10) 120mEq Potassium Chloride, RED
10A (complete 9-10) 120mEq Potassium Chloride, RED 11A (flush) 60mL Saline, BLACK
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Syringes 9A, 10A, 9B, 10B, 9C and 10C each contain 120 milliequivalents of potassium chloride for a total of 240 milliequivalents of potassium chloride in each set. Each syringe containing potassium chloride will have a RED label which contains the name of the chemical, chemical amount, and the designated syringe number.
After the Medical Team prepares the syringes and draws the chemical for primary set A, the Medical
Team Leader shall enter the chamber and attach the IV tubing to the catheter site.
Method 2
CHEMICAL CHART 2 Primary SET A Syringe No. Label
1A (compete 1-2) 2.5 g Pentobarbital GREEN
2A (complete 1-2) 2.5 g Pentobarbital GREEN
3A (flush) 60mL Saline, BLACK
4A (complete 4-5) 60mg Pancuronium Bromide, BLUE 5A (complete 4-5) 60mg Pancuronium Bromide, BLUE 6A (flush) 60mL Saline, BLACK 7A (complete 7-8) 120mEq Potassium Chloride, RED
8A (complete 7-8) 120mEq Potassium Chloride, RED
9A (flush) 60mL Saline, BLACK CHEMICAL CHART 2 CHEMICAL CHART 2 Backup Set B Backup Set C
Syringe No. Label Syringe No. Label
1B (complete 1-2) 2.5 g Pentobarbital GREEN 1C (complete 1-2) 2.5 g Pentobarbital GREEN
2B (complete 1-2) 2.5 g Pentobarbital GREEN 2C (complete 1-2) 2.5 g Pentobarbital GREEN 3B (flush) 60mL Saline, BLACK 3C (flush) 60mL Saline, BLACK 4B (complete 4-5) 60mg Pancuronium Bromide, BLUE 4C (complete 4-5) 60mg Pancuronium Bromide, BLUE 5B (complete 4-5) 60mg Pancuronium Bromide, BLUE 5C (complete 4-5) 60mg Pancuronium Bromide, BLUE
6B (flush) 60mL Saline, BLACK 6C (flush) 60mL Saline, BLACK
7B (complete 7-8) 120mEq Potassium Chloride, RED 7C (complete 7-8) 120mEq Potassium Chloride, RED
8B (complete 7-8) 120mEq Potassium Chloride, RED 8C (complete 7-8) 120mEq Potassium Chloride, RED 9B (flush) 60mL Saline, BLACK 9C (flush) 60mL Saline, BLACK
Syringe Preparation (Method 2)
Syringes 1A, 2A, 1B, 2B, 1C, and 2C each contain 2.5 gm of pentobarbital for a total of 5 grams in each set. Each syringe containing pentobarbital will have a GREEN label which contains the name of chemical, chemical amount and the designated syringe number.
Syringes 3A, 6A, 9A, 3B, 6B, 9B, 3C, 6C and 9C each contain 60 ml. of a saline solution and will have a BLACK label which contains the name of the chemical, chemical amount and the designated syringe number.
Syringes 4A, 5A, 4B, 5B, 4C and 5C each contain 60 mg of pancuronium bromide for a total of 120 mg of pancuronium bromide in each set. Each syringe containing pancuronium bromide will have a BLUE label which contains the name of the chemical, chemical amount and the designated syringe
number.
Syringes 7A, 8A, 7B, 8B, 7C and 8C each contain 120 milliequivalents of potassium chloride for a total of 240 milliequivalents of potassium chloride in each set. Each syringe containing potassium
chloride will have a RED label which contains the name of the chemical, chemical amount and the designated syringe number.
After the Medical Team prepares the syringes and draws the chemical for primary set A, the Medical
Team Leader shall enter the chamber and attach the IV tubing to the catheter site.
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Method 3
CHEMICAL CHART 3 Primary Set A Syringe No. Label
1A (complete 1-4) 1.25 g Sodium Pentothal, GREEN
2A (complete 1-4) 1.25 g Sodium Pentothal, GREEN
3A (complete 1-4) 1.25 g Sodium Pentothal, GREEN
4A (complete 1-4) 1.25 g Sodium Pentothal, GREEN 5A (flush) 60mL Saline, BLACK CHEMICAL CHART 3 CHEMICAL CHART 3
Backup Set B Backup Set C
Syringe No. Label Syringe No. Label
1B (complete 1-4) 1.25 g Sodium Pentothal, GREEN 1C (complete 1-4) 1.25 g Sodium Pentothal, GREEN
2B (complete 1-4) 1.25 g Sodium Pentothal, GREEN 2C (complete 1-4) 1.25 g Sodium Pentothal, GREEN 3B (complete 1-4) 1.25 g Sodium Pentothal, GREEN 3C (complete 1-4) 1.25 g Sodium Pentothal, GREEN
4B (complete 1-4) 1.25 g Sodium Pentothal, GREEN 4C (complete 1-4) 1.25 g Sodium Pentothal, GREEN
5B (flush) 60mL Saline, BLACK 5C (flush) 60mL Saline, BLACK
Syringe Preparation (Method 3)
Syringes 1A, 2A, 3A, 4A, 1B, 2B, 3B, 4B, 1C, 2C, 3C, and 4C each contain 1.25 gm/50ml. of sodium pentothal / 1 in 50 ml. of sterile water in four (4) 60 ml. syringes for a total dose of 5 grams of sodium pentothal in each set. Each syringe containing sodium pentothal will have a GREEN label which contains the name of chemical, chemical amount, and the designated syringe number.
Syringes 5A, 5B, and 5C each contain 60 ml. of a saline solution and will have a BLACK label which contains the name of the chemical, chemical amount, and the designated syringe number.
After the Medical Team prepares the syringes and draws the chemical for primary set A, the Medical
Team Leader shall enter the chamber and attach the IV tubing to the catheter site.
Method 4
CHEMICAL CHART 4 Primary Set A Syringe No. Label 1A (complete 1-2) 2.5 g Pentobarbital GREEN
2A (complete 1-2) 2.5 g Pentobarbital GREEN
3A (flush) 60mL Saline, BLACK CHEMICAL CHART 4 CHEMICAL CHART 4
Backup Set B Backup Set C
Syringe No. Label Syringe No. Label
1B (complete 1-2) 2.5 g Pentobarbital GREEN 1C (complete 1-2) 2.5 g Pentobarbital GREEN
2B (complete 1-2) 2.5 g Pentobarbital GREEN 2C (complete 1-2) 2.5 g Pentobarbital GREEN 3B (flush) 60mL Saline, BLACK 3C (flush) 60mL Saline, BLACK
Syringe Preparation (Method 4)
Syringes 1A, 2A, 1B, 2B, 1C, and 2C each contain 2.5 gm of pentobarbital for a total of 5 grams in each set. Each syringe containing pentobarbital will have a GREEN label which contains the name of chemical, chemical amount and the designated syringe number.
Syringes 3A, 3B, and 3C each contain 60 ml. of a saline solution and will have a BLACK label which contains the name of the chemical, chemical amount and the designated syringe number.
After the Medical Team prepares the syringes and draws the chemical for primary set A, the Medical
Team Leader shall enter the chamber and attach the IV tubing to the catheter site.

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Note: The chemical amounts as set forth in chemical charts 1, 2, 3, and 4 are designated for the execution of persons weighing 500 pounds or less. The chemical amounts will be reviewed and may be revised as necessary if weight exceeds 500 pounds.
Note: The full dose contained in each syringe of the chemical set in use must be administered to the condemned person and subsequently documented by the designated recorder. The quantities of the chemicals drawn and administered may not be changed in any manner without prior approval of the
Director of IDOC after consultation with the Medical Team Leader. If all electrical activity of the heart ceases prior to administering all of the chemicals in the set, the Medical Team members must continue to follow this protocol and administer all remaining chemicals in the set being used in the
order and amounts set forth in the applicable chemical chart.
E. Preparation, Movement, and Monitoring of the Condemned Person
The condemned person will be offered a mild sedative. The sedative must be provided to the condemned person no later than four hours prior to the execution unless it is determined medically
necessary.
Prior to moving the condemned person from the isolation cell to the Execution Preparation Room, the Director of IDOC will confer with the Idaho Attorney General, or designee, and the Idaho Governor, or
designee, to confirm there is no legal impediment to proceeding with the lawful execution.
The witnesses will be escorted to the designated witness areas.
At the designated time, the Escort Team will secure the condemned person to the medical gurney. After
the condemned person has been secured to the medical gurney, the Escort Team Leader will personally check the restraints which secure the condemned person to the medical gurney to ensure they are not so restrictive as to impede the condemned person’s circulation, yet sufficient to prevent manipulation of the catheters and IV lines. The Escort Team will move the condemned person to the Execution Preparation Room.
The IMSI Warden or designee will confirm audio and video feeds from the Execution Preparation Room and the Execution Chamber are functioning and transmitting to the witness areas prior to the condemned person being moved from their cell. The microphones in the Execution Preparation Room and Execution Chamber will be positioned to broadcast any utterances or noises made by the condemned person. The audio and video feeds from the Execution Preparation Room will continue to transmit to the witness areas through the duration of the preparation process. After peripheral or central
line venous access has been established, the Escort Team Leader will again check the restraints which secure the condemned person to the medical gurney to ensure they are not so restrictive as to impede the condemned person’s circulation, yet sufficient to prevent manipulation of the catheters and IV lines. The designated Medical Team Member will affix the EKG leads at appropriate locations on the condemned person. The Escort Team will move the condemned person to the Execution Chamber on the medical gurney.
Once the medical gurney is secured in the Execution Chamber, the Medical Team Leader will attach the leads to the electrocardiograph (EKG) monitor and confirm that the EKG monitor is functioning properly. The Medical Team Leader will ensure the proper graph paper is used. A backup EKG monitor must be on site and readily available if necessary. The Medical Team Leader will then attach the IV lines to the established venous access catheter sites and ensure they are flowing appropriately.
The Medical Team Leader will assign a Medical Team Member to monitor the EKG. The assigned Medical Team Member will observe the EKG monitor and mark the EKG graph paper at the commencement and completion of the administration of each chemical along with their assigned identifier.
Throughout the execution procedure, the Medical Team Leader and the Medical Team Member assigned to monitor the EKG are responsible for monitoring the condemned person’s level of
consciousness. The remaining Medical Team Members will maintain continual observation of the condemned person using one or more of the following methods: direct observation, audio equipment, video equipment, and television monitor as well as any other approved method(s) deemed necessary by
the Medical Team Leader.
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The Medical Team Leader will confirm the video and audio feeds in the Execution Chamber are functioning properly and transmitting to the Medical Team Room. The audio and video feeds will continue to transmit to the Medical Team Room throughout the execution process. The audio feed from the Execution Chamber will continue to transmit to the witness areas throughout the execution process.
The IMSI Warden must ensure there is a person present in the Execution Chamber throughout the
execution who is able to communicate with the condemned person in their primary language. This person will be positioned to clearly see, hear, and speak to the condemned person throughout the execution. If the IMSI Warden can communicate with the condemned person in their primary language, he may serve in that capacity.
Once the condemned is prepared, the IMSI Warden must read aloud a summary of the death warrant.
The IMSI Warden will then ask the condemned person if he wishes to make a last statement and provide an opportunity to do so.
The IMSI Warden will offer the condemned person an eye covering.
F. Intravenous Lines
Intravenous (IV) catheters necessary to carry out the execution will be inserted in the Execution Preparation Room.
The assigned Medical Team Members will determine the best sites on the condemned person to insert IV catheters. Peripheral venous access is the preferred method of IV catheter placement, unless the Medical Team Leader determines it is not possible to place two reliable peripheral catheters. If using
peripheral venous access, a primary and backup IV catheter will be placed. If utilizing central line venous access as directed by the Medical Team Leader, a single IV catheter will be placed. All IV catheter insertions will be inserted by appropriately trained and certified or licensed persons using their professional training and experience. The peripheral insertion sites in order of preference will be arms, hands, ankles, and feet, with placement determined by the Medical Team Leader.
The Medical Team will make every reasonable effort to ensure that no unnecessary pain or suffering is inflicted on the condemned person during the IV catheter insertion process. At the discretion of the Medical Team Leader, the Medical Team may use a localized anesthetic to numb the venous access site.
To ensure proper insertion in the vein, the assigned Medical Team Members should confirm the flashback of blood at the catheter hub.
Prior to leaving the Execution Preparation Room, the assigned Medical Team Members must ensure the catheter is properly secured with the use of tape or adhesive material and/or sutures (if necessary) out of reach of the condemned person’s hands.
Once the condemned person is moved into the Execution Chamber and the Medical Team Leader has attached the IV lines to the inserted IV catheter(s), a flow of saline will be started in each line and administered at a slow rate to keep the line open.
Should it be determined that the use of the backup IV catheter is necessary, a complete set of backup chemicals will be administered in the backup IV as set forth in the applicable chemical chart.
G. Administration of Chemicals
The primary peripheral IV catheter or central line catheter will be used to administer the chemicals. Any failure of a venous access line must be immediately reported to the IMSI Warden. If directed to proceed, the backup peripheral IV catheter will be utilized.
The IV catheter or central line in use must not be covered and must remain visible throughout the entire execution process.
The IMSI Warden must physically remain in the Execution Chamber with the condemned person throughout the administration of the chemicals. The IMSI Warden must remain in a position sufficient to clearly observe the condemned person and all IV sites for any potential problems and must immediately
notify the Medical Team Leader and Director of IDOC should any issue occur. Upon receipt of such notification, the Director of IDOC will stop the proceedings, consult with the Medical Team Leader, and
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then direct the Medical Team to continue the execution process or discontinue the execution. The Medical Team Leader shall appoint a Medical Team recorder. The Medical Team recorder is responsible for completing the applicable sequence of chemical form (see appendices 1 through 4). The recorder must document on the form the amount of each chemical administered and confirm that it was administered in the order set forth in the chemical chart. Any deviation from the written procedure must
be noted and explained on the form.
At the time the execution is to commence and prior to administering the chemicals, the Director of IDOC will confirm with the Idaho Attorney General, or designee, and the Idaho Governor, or designee, that there is no impediment to proceeding with the execution. Upon receipt of confirmation that there is no impediment, the Director of IDOC will instruct the IMSI Warden to commence the process to carry out the sentence of death. If there is an impediment to the execution, the Director of IDOC must instruct the IMSI Warden to stop the process and to notify the condemned person and witnesses that the execution has been stayed or delayed. The IMSI Warden, or designee, will notify the IDOC Public Information
Officer and other staff as necessary.
Upon receiving the order to commence the execution process from the Director of IDOC, the IMSI Warden will instruct the Medical Team Leader to begin administering the chemicals.
Methods 1 and 2 The Medical Team Leader will instruct the assigned Medical Team member to begin dispensing the first
chemical.
Upon direction from the Medical Team Leader, the assigned Medical Team member will visually and verbally confirm the chemical name on the syringe and then administer the full dose of either sodium pentothal/or pentobarbital immediately followed by the saline flush. The saline is administered as a secondary precaution to further ensure the line is functioning properly and flushed between each chemical.
After the sodium pentothal/or pentobarbital and saline have been administered and before the Medical Team members begin administering the pancuronium bromide, the Medical Team Leader must confirm the condemned person is unconscious by direct examination. The Medical Team Leader, dressed in a manner to preserve anonymity, will enter the Execution Chamber to physically confirm the condemned person is unconscious by using all necessary and appropriate techniques such as giving verbal
stimulus, soliciting an auditory response, touching the eyelashes, conducting a sternal rub. The Medical Team Leader will also confirm that the IV line remains affixed and functioning properly.
No further chemicals will be administered until the Medical Team Leader has confirmed the condemned person is unconscious. After three minutes have elapsed since the administration of the sodium pentothal/or pentobarbital, the Medical Team Leader will assess and confirm that the condemned person is unconscious. The Medical Team Leader will verbally advise the IMSI Warden of the
condemned person’s status.
If the condemned person is conscious, the Medical Team must assess the situation to determine the reason, if possible. The Medical Team Leader must communicate this information to the IMSI Warden, along with all Medical Team input. The IDOC Director will determine how to proceed, including whether to start the procedure over at a later time or stand down.
If deemed appropriate, the IMSI Warden may instruct the Medical Team to administer an additional 5 grams of sodium pentothal/or pentobarbital followed by the saline flush from backup set B.
Upon administering the sodium pentothal/or pentobarbital and saline from backup set B, the Medical Team Leader will again physically confirm the condemned person is unconscious and verbally advise the IMSI Warden of the same. Throughout the entire procedure, the Medical Team members and the IMSI Warden will continually monitor the condemned person using all available means to ensure that the
condemned person remains unconscious and that there are no complications.
Only after receiving oral confirmation from the Medical Team Leader that the condemned person is unconscious and three minutes have elapsed since commencing the administration of the sodium
pentothal/or pentobarbital and saline from backup set B, will the IMSI Warden instruct the Medical Team Leader to proceed with administering the next chemicals.
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When directed by the IMSI Warden, the Medical Team Leader will instruct the assigned Medical Team members to begin administering the full doses of the remaining chemicals (pancuronium bromide and potassium chloride), each followed by a saline flush as set forth in the applicable chemical chart.
If after administering the potassium chloride and subsequent saline flush, the electrical activity of the condemned person’s heart has not ceased, the additional potassium chloride and saline flush contained
in backup set B must be administered.
Methods 3 and 4 The Medical Team Leader will instruct the assigned Medical Team member to begin dispensing the first chemical.
Upon direction from the Medical Team Leader, the assigned Medical Team member will visually and verbally confirm the chemical name on the syringe and then administer the full dose of either sodium pentothal/or pentobarbital immediately followed by the saline flush.
If after administering the sodium pentothal/or pentobarbital and subsequent saline flush in set A, and 10 minutes have elapsed, and the electrical activity of the condemned person’s heart has not ceased, the Medical Team will draw chemical for backup set B. The additional sodium pentothal/or pentobarbital and
saline flush contained in backup set B shall then be administered.
If after administering the sodium pentothal/or pentobarbital and subsequent saline flush in set B, and 10 minutes have elapsed, and the electrical activity of the condemned person’s heart has not ceased, the
Medical Team will draw chemical for backup set C. The additional sodium pentothal/or pentobarbital and saline flush contained in backup set C shall then be administered.
Completion of Execution for All Methods For chemical set A and chemical set B (if used) and chemical set C (if used), the full dose contained in each syringe must be administered to the condemned person and subsequently documented by the designated recorder. The quantities of the chemicals drawn and administered may not be changed in any manner without prior approval of the Director of IDOC after consultation with the Medical Team Leader.
If all electrical activity of the heart ceases prior to administering all the chemicals in the chemical set being administered (A, B, or C), the Medical Team members must continue to follow this protocol and
administer all remaining chemicals in that set in the order and amounts set forth in the applicable chemical chart.
When all electrical activity of the heart has ceased as shown by the EKG monitor, the Medical Team Leader will advise the Ada County Coroner that the procedure has been completed. The Medical Team Leader will ensure that the EKG monitor runs a print-out strip for two minutes after the last chemical is administered.
The Ada County Coroner will enter the execution chamber to examine and pronounce the death of the condemned person. The IMSI Warden will then announce that the sentence of death has been carried out. The witnesses will be escorted from the Execution Unit back to the respective staging and exit locations.

H. Documentation of Chemicals and Stay
In the event that a pending stay results in more than a two-hour delay, the catheter may be removed in consultation with the Medical Team Leader and the condemned person will be returned to the isolation cell until further notice.
The Medical Team recorder will account for all chemicals that were drawn but not administered and document, in the applicable sequence of chemical form (see appendices 1 through 4), the chemical name, syringe identification code, amount, date, and the time. Time will be recorded based on the approved Medical Team Room clock. The Medical Team Leader and the Medical Team recorder each
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will sign the applicable sequence of chemical form (see appendices 1 through 4). The Medical Team Leader will give the unopened, unused chemicals to a member of the Administrative Team.
All logs, the applicable sequence of chemical forms (see appendices 1 through 4), the list of identifiers, and the EKG monitor tape will be submitted to the designated member of the Administrative Team responsible for retention.
Upon completion of the execution or when a stay exceeding 24 hours is granted, the Administrative Team will ensure the Medical Team has disposed of all medical waste and supplies to include unused, drawn chemicals in accordance with state of Idaho and federal law.
I. Contingency Procedure
A portable cardiac monitor/defibrillator will be readily available on site in the event that the condemned person goes into cardiac arrest at any time prior to administering the chemicals; trained medical staff must make every effort to revive should this occur, unless the condemned person has signed an Idaho Physician Orders for Scope of Treatment form.
Trained medical personnel and emergency transportation will be available in proximity to respond to the condemned person should any medical emergency arise at any time before the order to proceed with the execution is issued by the Director of IDOC.
The Director of IDOC will be immediately notified if any part of the execution process is not proceeding according to these procedures. The Director of IDOC will stop the proceedings, consult with the Medical Team Leader, and then direct the Medical Team to continue with or discontinue the execution.

*Appendices 1-4 below

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IDAHO DEPARTMENT OF CORRECTION Sequence of Chemical Form – Method 1
Inmate: IDOC #: Date:
Chemical Chart 1: PRIMARY SET A
Syringe
No. Label Time
Administered Comments
1A 1.25 g Sodium Pentothal, GREEN
2A 1.25 g Sodium Pentothal, GREEN
3A 1.25 g Sodium Pentothal, GREEN
4A 1.25 g Sodium Pentothal, GREEN
5A 60mL Saline, BLACK
6A 60mg Pancuronium Bromide, BLUE
7A 60mg Pancuronium Bromide, BLUE
8A 60mL Saline, BLACK
9A 120mEq Potassium Chloride, RED
10A 120mEq Potassium Chloride, RED
11A 60mL Saline, BLACK

Chemical Chart 1: BACKUP SET B
Syringe
No. Label Time
Administered Comments
1B 1.25 g Sodium Pentothal, GREEN
2B 1.25 g Sodium Pentothal, GREEN
3B 1.25 g Sodium Pentothal, GREEN
4B 1.25 g Sodium Pentothal, GREEN
5B 60mL Saline, BLACK
6B 60mg Pancuronium Bromide, BLUE
7B 60mg Pancuronium Bromide, BLUE
8B 60mL Saline, BLACK
9B 120mEq Potassium Chloride, RED
10B 120mEq Potassium Chloride, RED
11B 60mL Saline, BLACK

Chemical Chart 1: BACKUP SET C
Syringe
No. Label Time
Administered Comments
1C 1.25 g Sodium Pentothal, GREEN
2C 1.25 g Sodium Pentothal, GREEN
3C 1.25 g Sodium Pentothal, GREEN
4C 1.25 g Sodium Pentothal, GREEN
5C 60mL Saline, BLACK
6C 60mg Pancuronium Bromide, BLUE
7C 60mg Pancuronium Bromide, BLUE
8C 60mL Saline, BLACK
9C 120mEq Potassium Chloride, RED
10C 120mEq Potassium Chloride, RED
11C 60mL Saline, BLACK
IDAHO DEPARTMENT OF CORRECTION Sequence of Chemical Form- Method 2

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Inmate: IDOC #: Date:
Chemical Chart 2: PRIMARY SET A
Syringe
No. Label Time
Administered Comments
1A 2.5 g Pentobarbital GREEN
2A 2.5 g Pentobarbital GREEN
3A 60mL Saline, BLACK
4A 60mg Pancuronium Bromide, BLUE
5A 60mg Pancuronium Bromide, BLUE
6A 60mL Saline, BLACK
7A 120mEq Potassium Chloride, RED
8A 120mEq Potassium Chloride, RED
9A 60mL Saline, BLACK

Chemical Chart 2: BACKUP SET B
Syringe
No. Label Time
Administered Comments
1B 2.5 g Pentobarbital GREEN
2B 2.5 g Pentobarbital GREEN
3B 60mL Saline, BLACK
4B 60mg Pancuronium Bromide, BLUE
5B 60mg Pancuronium Bromide, BLUE
6B 60mL Saline, BLACK
7B 120mEq Potassium Chloride, RED
8B 120mEq Potassium Chloride, RED
9B 60mL Saline, BLACK

Chemical Chart 2: BACKUP SET C
Syringe
No. Label Time
Administered Comments
1C 2.5 g Pentobarbital GREEN
2C 2.5 g Pentobarbital GREEN
3C 60mL Saline, BLACK
4C 60mg Pancuronium Bromide, BLUE
5C 60mg Pancuronium Bromide, BLUE
6C 60mL Saline, BLACK
7C 120mEq Potassium Chloride, RED
8C 120mEq Potassium Chloride, RED
9C 60mL Saline, BLACK
IDAHO DEPARTMENT OF CORRECTION Sequence of Chemical Form- Method 3

(Last updated 10/11/2024)
Inmate: IDOC #: Date:
Chemical Chart 3: PRIMARY SET A
Syringe
No. Label Time
Administered Comments
1A 1.25 g Sodium Pentothal, GREEN
2A 1.25 g Sodium Pentothal, GREEN
3A 1.25 g Sodium Pentothal, GREEN
4A 1.25 g Sodium Pentothal, GREEN
5A 60mL Saline, BLACK

Chemical Chart 3: BACKUP SET B
Syringe
No. Label Time
Administered Comments
1B 1.25 g Sodium Pentothal, GREEN
2B 1.25 g Sodium Pentothal, GREEN
3B 1.25 g Sodium Pentothal, GREEN
4B 1.25 g Sodium Pentothal, GREEN
5B 60mL Saline, BLACK

Chemical Chart 3: BACKUP SET C
Syringe
No. Label Time
Administered Comments
1C 1.25 g Sodium Pentothal, GREEN
2C 1.25 g Sodium Pentothal, GREEN
3C 1.25 g Sodium Pentothal, GREEN
4C 1.25 g Sodium Pentothal, GREEN
5C 60mL Saline, BLACK
IDAHO DEPARTMENT OF CORRECTION Sequence of Chemical Form- Method 4

(Last updated 10/11/2024)

Inmate: IDOC #: Date:
Chemical Chart 4: PRIMARY SET A
Syringe
No.
Label Time
Administered
Comments
1A 2.5 g Pentobarbital GREEN
2A 2.5 g Pentobarbital GREEN
3A 60mL Saline, BLACK

Chemical Chart 4: BACKUP SET B
Syringe
No.
Label Time
Administered
Comments
1B 2.5 g Pentobarbital GREEN
2B 2.5 g Pentobarbital GREEN
3B 60mL Saline, BLACK

Chemical Chart 4: BACKUP SET C
Syringe
No.
Label Time
Administered
Comments
1C 2.5 g Pentobarbital GREEN
2C 2.5 g Pentobarbital GREEN
3C 60mL Saline, BLACK