Carpuject!?

[hendersonar]

My hospital uses the carpuject cartridges, but not the injectors. We draw up the meds into a syringe with a blunt tip and just give it that way. My question is this: do you inject any air into the cartridge? I was always taught no, and that seemed like common sense (such a small space, there's already an air bubble... laws of physics... where's that extra air going to go?). So at work I was drawing up some morphine and I'm not entirely sure what happened but the end of the cartridge popped off and when I showed another nurse she asked if I put air into it and I said I wasn't sure, I wasn't really paying attention... just trying to pull up the med. I think I accidently pushed some air in and that's why it popped off. She thinks I didn't put air into it and that's why it broke. Now there's a huge debate.

SO: yes or no... air into tubex cartridges or not?!

[tigkaskit, BSN]

No air.

[ana78ng]

No air. Air = screwed in tube closure device unscrews and flies across the room, with your med. I learned that quickly while giving IVP meds in nursing school. We have carpujects, but not many use them.

[dreavt, BSN, RN]

Definitely no air! Learned the hard way when I was on orientation -- we have the carpuject injectors, but few use them, and they are often hard to find. I was in a rush to get morphine, knew it was possible to draw out of the carpuject vials, injected air like I do when drawing meds out of a regular vial -- cap popped off and 2 mg of morphine sprayed onto me, the counter, etc. -- agh. Have since drawn out of them many times with no problems, just *don't* inject air first.

[fiveofpeep]

no air. I have shot off the top a couple of times when I tried to inject air when the morphine was unruly in sucking into my syringe. morphine smells really bad btw when it explodes all over.

[sunnycalifRN]

here's how I use the Carpujects. I used to do what you do, extracting the med with the blunt needle, etc, and BTW, no injection of air.

here's how I do it now:

get a plunger from a TB syringle (I keep a couple handy at all times). then, just as you do when using the Carpuject injector, clear the air using the plunger to push the stopper, then you can connect the Carpuject to your IV access point and inject the specific dose followed by a flush

big advantage of this is when you have to waste; you know exactly how much you're wasting because there's no air to confuse matters

[cb_rn]

No air. Air = screwed in tube closure device unscrews and flies across the room, with your med. I learned that quickly while giving IVP meds in nursing school. We have carpujects, but not many use them.

HAHAHA I did that once in NS too and got a face full of narcotic. It wasnt as funny back then.

[murphyle, BSN, RN]

We do blunt-needle draws off Capuject vials all the time - our Dilaudid, morphine and Valium all come that way, and I've only ever seen one Carpuject device down here, much less anybody ever using one. In my experience you can get away with injecting a limited amount of air (not more than 0.5 mL) into the vial without popping the cap, but at that point you haven't accomplished much in terms of making the draw easier, and you still risk an opioid shower if you happen to get an overpressurized vial. Personally, I don't bother.

For fractional doses, I draw the entire vial into a syringe, discard the vial and waste from the syringe as needed. Quick and accurate.

[I<3H2O, BSN, RN]

here's how I use the Carpujects. I used to do what you do, extracting the med with the blunt needle, etc, and BTW, no injection of air.

here's how I do it now:

get a plunger from a TB syringle (I keep a couple handy at all times). then, just as you do when using the Carpuject injector, clear the air using the plunger to push the stopper, then you can connect the Carpuject to your IV access point and inject the specific dose followed by a flush

big advantage of this is when you have to waste; you know exactly how much you're wasting because there's no air to confuse matters

This is brilliance!

[StarryEyed, RN]

The only times I've had the other end pop off is if I inject more than one 1ml worth of air (or whatever amount is in the vial to begin with) It's only happened to me while i was still orienting. Then i figured it out. I always inject the amount of medication in the vial and never had a problem

[psu_213, BSN, RN]

No air. I think it is pretty simple with the top popping off--you inject air up into it, increase the pressure, top pops off. Using the laws of physics, this is pretty simple. Not sure what this other nurse was thinking.

[ScarryBear,RN]

Nope. If I HAVE to draw up with a syringe I use my fingernail to push the stopper to break it free. Then when I draw it up the stopper moves down to prevent a vapor lock and it draws up easily. I would ask your pharmacy if they have an extra carpujet, there are usually some sent with large shipments.