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!
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. 😉
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.
It’s crazy how we take seemingly simple tasks for granted! Congratulations on almost finishing CA-1 year! 🙂