Drawing up meds in syringe.....How to?

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I have the summer off and have some syringes and sterile water to practice with so here is the problem I seem to have. How does a person hold a vial or an ampule in one hand (the nondominant hand) while pulling down on the syringe (without touching the needles to the sides of anything) and all the while using one hand to pull the med out and steady the syringe? And while pulling down on the syringe I cannot seem to keep myself from touching the plunger part of the syringe.

I am all fumbles when it comes to this. I cannot for the life of me put the needle into the ampule without touching the sides of the ampule, nor can I figure out how to keep the needle from touching the sides of the ampule when I invert it.

Now, when I come to having to do this for the first time on a real live patient, my shaking hands will really add to this issue.

Does this all come with lots of practice and should I just keep plugging along with my practicing? Every time I watch a video the nurses all make it look so easy.

Any tips would be appreciated.

Thanks

Gompers, BSN, RN

2,691 Posts

Specializes in NICU.

Okay, I'm a bit confused.

Why can't you let the needle touch the inside of the ampule?

And why can't you touch the plunger?

Dratz

215 Posts

According to my Fundamentals text Potter and Perry (p. 886 3rd edition, Canadian edition), it explains that you are not supposed to allow the needle tip of the shaft to touch the rim of the ampule. (I wonder if that means I can still let the needle touch the sides once it is inside the solution in the ampule? Apparently the rationale being that the broken rim of the ampule is contaminated. Easier said than done!!!

As for touching the barrel, according to page 881 of the text, it states that "to maintain sterility, the nurse avoids letting any unsterile object touch the tip or the inside of the barrel, the hub or shaft of the plunger or the needle" and then it has a little picture of the barrel and it says "avoid touching".

So.......go figure??? I know that as a student I will probably be pretty nervous the first time I ever draw a med and heaven forbid if I accidentally touch anything!!.

I don't know, I am just studying my notes here and that is what I am being told.

:banghead:

Dratz

215 Posts

Oops sorry...I meant Barrel ...I cannot touch the barrel.

Gompers, BSN, RN

2,691 Posts

Specializes in NICU.

Well, I would like to see a video of their technique myself!

It sounds impossible to me. Anyone else have any comments?

You have to touch the barrel and the plunger when drawing up meds. How in the world else are you supposed to get a grip on it?

Don't you just love nursing textbooks?

jktb

21 Posts

i have never heard that info before(not toching the sides of ampule) , i think there is no problemms with that , but yes you should not touch the plunger because you will contaminate the med.

Gompers, BSN, RN

2,691 Posts

Specializes in NICU.
i have never heard that info before(not toching the sides of ampule) , i think there is no problemms with that , but yes you should not touch the plunger because you will contaminate the med.

But you need to touch the plunger to work the syringe.

Dratz

215 Posts

Yes, I know about the plunger, my mistake when I first explained myself. I think I was going on my instructor who went completely insane when I touched the sides of the ampule prior to w/d a med one time (my first attempt at nursing and my very first injection experience). I thought I had started a war or something with the way she reacted. So I am really trying to be so careful this time around in not doing that again.

And I am finding it hard not to brush up against the barrel as I pull the plunger back. So I take it that all just takes practice.

Thanks for the replies.

Dratz

215 Posts

Well, I would like to see a video of their technique myself!

It sounds impossible to me. Anyone else have any comments?

You have to touch the barrel and the plunger when drawing up meds. How in the world else are you supposed to get a grip on it?

Don't you just love nursing textbooks?

Exactly my point!!......the text says one thing while in reality it is another thing!!.

Dratz

215 Posts

LOL...:rotfl: Aint nursing school grand. I just finished reading all the posts. Ok...the barrel is that thingie that is attached to the plunger. The plunger we can touch......the barrel we cannot touch!!. But.....I am finding it pretty tricky to PULL BACK THE DERN PLUNGER without touching the barrel. Does that make sense?

As for the needle, No we were taught never to touch the sides the rim or anything on the ampule which is such a finicky little thing to begin with and tips over on the counter just by looking at it...so go figure, once I get the dern needle in the ampule WITHOUT touching the rim....then I am thinking oh lord here I am touching the sides of the ampule...so then I think how the heck can I now invert this dern ampule without touching the rim, the sides and anything else with the needle? Surely to gawd there must be a way around all this insanity?

Or.......like I was asking before, as you practice does it become easier? What are the rules in the "real world". If I follow the silly textbook then I can't get anything dirty lol.

Sheesh!! hehe too freaking funny:rotfl: :rotfl: :rotfl:

Gompers, BSN, RN

2,691 Posts

Specializes in NICU.
LOL...:rotfl: Aint nursing school grand. I just finished reading all the posts. Ok...the barrel is that thingie that is attached to the plunger. The plunger we can touch......the barrel we cannot touch!!. But.....I am finding it pretty tricky to PULL BACK THE DERN PLUNGER without touching the barrel. Does that make sense?

As for the needle, No we were taught never to touch the sides the rim or anything on the ampule which is such a finicky little thing to begin with and tips over on the counter just by looking at it...so go figure, once I get the dern needle in the ampule WITHOUT touching the rim....then I am thinking oh lord here I am touching the sides of the ampule...so then I think how the heck can I now invert this dern ampule without touching the rim, the sides and anything else with the needle? Surely to gawd there must be a way around all this insanity?

Or.......like I was asking before, as you practice does it become easier? What are the rules in the "real world". If I follow the silly textbook then I can't get anything dirty lol.

Sheesh!! hehe too freaking funny:rotfl: :rotfl: :rotfl:

Okay, this is all ridiculous.

We always touch the ampule or vial when we're drawing up meds. Sometimes you have to add water or saline to reconstitue the meds - how are you supposed to shake it up without touching it??? I don't know who is telling students they can't touch the vial or ampule. This is ridiculous.

You also have to touch the barrel of the syringe to draw up and give your medication. I have no idea what these books and instructors are talking about. I have been working as a nurse for 8 years and have never heard that you can't pick up the vial or ampule, or that you can't touch the barrel of the syringe.

Dratz

215 Posts

No, you misunderstand. I said you cannot allow the NEEDLE to touch the rim of the ampule as it is considered contaminated once it has been snapped open. The text also states that you are not allowed to let the NEEDLE touch the sides of the ampule either. Which I think is ridiculous. And I totally agree with you about touching the BARREL of the syringe. I am finding it nearly impossible to not touch that part as I pull back on the plunger.

That is why it seems more difficult than it probably really is. I guess I will just have to wait until school is back in to get the real story on what you can or cannot touch but that is what my Fundamentals Text is telling me.

Thanks for your comments tho.

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