Safely Drawing Up And Labeling Medications

Every day as an anesthesiologist, I reconstitute, draw up, and administer antibiotics, hypnotics, narcotics, paralytics, inotropes/pressors, blood products, fluids, vasodilators, and a myriad of other medications. Each year, the FDA receives over 100,000 reports associated with a suspected medication error causing hospitalization, life-threatening emergency, morbidity, and even death!

In light of the recent headlines regarding the fatal administration of vecuronium instead of midazolam (Versed), I wanted to see how you all promote safe medication administration practices. Here are two things I do with virtually every medication.

First, I pre-label my syringes both sideways and circumferentially. Next, whenever I draw medications out of a vial, I have the inverted medication label facing me and the syringe label. This way, I can ensure I’m filling the right syringe with the right medication at the expected concentration.

Whether it’s cross-checking certain medications with a licensed provider, separating medications which look and sound similar, using electronically generated labels from medication QR codes, or even simple “off-the-protocol” tips, drop me a comment with what you do regarding medication safety and a tag a friend who might be interested in seeing suggestions! We need to do better!

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  1. Trauma/ER CRNP here. I have recently discovered your site, and am slowly deep diving through it while on shift. I love your teaching style, concise, clear, and calculated. You obviously do your homework, and make sure that the information is delivered in a small package of useful information. It plays well to our current cultures attention span. And I love the little things like this, that when put into practice can have stellar results.

    PS: PUBG or Fortnite?

    • Hahaha, I appreciate it man! It’s hard to balance complexity with brevity, but I try to tailor things so people of all backgrounds can understand. 🙂

      Let’s just say I’ve dabbled in Fortnite, but don’t play it anymore. 😉

  2. Thank you! CA-1 here. While it seems so simple, drawing up drugs, it isn’t a skill most anesthesia residents have when they start their training. I remember my first week, drawing up meds. My co-resident and I both were struggling. First he cut himself while cracking open the epi vial and nearly a moment later I stabbed myself with a blunt needle while drawing up propofol. Wow, I’ve come a long way since day one, but the struggle was real for what we would all imagine are such simple tasks.


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