Quote from NICU_babyRN
We usually draw up the 0.07ml into a TB syringe and then add saline to it to make it 0.7ml total. So we don't dilute the lasix or other drug in it's original vial. We draw up only what we need from it.
This practice sounds dangerous to me. When drawing up 0.07ml, you also have a bit more medicine in the syringe tip, possibly as much as 0.05ml. So if we add saline to that syringe (vs adding that syringe to saline), we have more medicine than we have accounted for.
We have a policy for fentanyl dilution. It comes 100mcg/2ml. We draw up the 2ml, then mix with 18ml NS to equal 100mcg/20ml or 5mcg/ml. Then we draw our dose from that.
I think that it's safer to dilute first.