What do you do with the extra volume in an ampoule?

  1. I am a newly graduated nursing student and my friends and I have encountered differences in how to deal with volume differences in IV medication drawn from ampoules. One heparin ampoule had 0.3ml instead of 0.2ml when drawn up (5000IU in 0.2ml was written on the ampoule).

    1) One nurse said discard the whole medication; you dont know how much is the correct dose.

    2) second nurse said discard the difference and you will be fine

    3) third nurse said discrepancies could be due to the syringe; allow for +/-10% difference.

    4) fourth nurse said give the whole amount: Extra volume could be due to "condensation" in the factory???????????

    What r your thoughts? What would you do?
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  2. 9 Comments

  3. by   canoehead
    I almost always find a little extra in each container. I discard the extra volume.
  4. by   URO-RN
    options 2 and/or 3.
  5. by   Daytonite
    The manufactures always put a little bit extra into each ampule. However, the dilution of the solution is exactly what it says on the label, so do not assume that because there is a couple of tenths of a cc left in a vial that you also need to draw it up and use it. You base the amount of the drug you need by the strength of the solution.

    What caught my eye about your post was the title: What do you do with the extra volume in the ampule? Well, what we used to do is have target practice if we wanted to waste the drug! We had a funny little symbol that was engraved into the sink near where our med carts were kept, so we aimed for it and using our syringes, shot the remaining drug at this target. It was the nursing version of shooting hoops!
  6. by   pricklypear
    Definitely toss the excess (or squirt it around in cool patterns on the ceiling, or on the front of your coworker's pants). I agree with Daytonite - there is always a little excess in the vial, but the concentration is correct. If the vial is sealed, how could condensation ever amount to more than was originally there?
  7. by   ceecel.dee
    Discard the excess.
  8. by   lyallch
    Thank you guys. You confirmed my beliefs that the excess should be discarded, despite what the other nurses said.
  9. by   Bipley
    Quote from lyallch
    I am a newly graduated nursing student and my friends and I have encountered differences in how to deal with volume differences in IV medication drawn from ampoules. One heparin ampoule had 0.3ml instead of 0.2ml when drawn up (5000IU in 0.2ml was written on the ampoule).

    1) One nurse said discard the whole medication; you dont know how much is the correct dose.

    2) second nurse said discard the difference and you will be fine

    3) third nurse said discrepancies could be due to the syringe; allow for +/-10% difference.

    4) fourth nurse said give the whole amount: Extra volume could be due to "condensation" in the factory???????????

    What r your thoughts? What would you do?
    Most drugs have some overfill. If the dose is 5000u/ml then only give 1ml if the dose is 5000u. Trust whatever the label says and know there is overfill.

    The only time it is an issue is when you are making a narcotic IV. Example, one time I had to push 25-20cc amps of Fentanyl through a filter needle. The order was for 500cc Fentanyl (terminal patient, NOTHING was getting him out of pain, absolutely nothing!). There was enough overfill in each amp that I only needed 24 amps to get my 500cc. I only pulled 24 amps out but I was questioned about it later. When I explained why I only needed 24 amps then there was no problem. But that's how much overfill there can be.

    Now Pharmacy does it and it's their problem.

    Edit to add: Remember, the concentration of the drug is the same regardless of the quantity in the amp. So if you admin the entire amp, you are giving a higher dose than ordered. Just throw away the remainder.
  10. by   Bipley
    Quote from pricklypear
    Definitely toss the excess (or squirt it around in cool patterns on the ceiling, or on the front of your coworker's pants).
    Especially fun to do with MVI.
  11. by   Thunderwolf
    Discard......

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