Drug administration in PACU

[SNIXRN]

Hi all!

I wanted to see other hospitals' practices for administering narcotics in PACU (adults or pediatrics).

For example, say you have a 100mcg vial of Fentanyl and want to give your patient a dose, how do you draw up the dose? How do you administer it? Do you draw up the whole vial in one syringe and administer the respective dose as needed from that syringe (e.g., give 25mcg now, then 25 mcg in 5 minutes)? Do you draw the dose you need at the time from the vial and later re-access the vial for additional doses? If, so, do you use the same syringe/needle?

With the pediatric population, do you use any sort of transfer device?

Any input would be appreciated. And, if you can at least tell me the state you are in, I would greatly appreciate that!

Thanks!

[brownbook]

I've only worked where the glass vials of fentanyl are available. We draw up the whole dose...100 mcg....then give what ever is ordered. I can't imagine any other option when using the glass vials. We don't have a pyxis.

Are you having problems or concerns with your fentanly dosing/wasting?

[HeySis, BSN, RN]

For fentanyl, I draw up the full vial in a syringe and give titrated doses from there. That syringe has to be labeled with the drug, concentration (mcg/ml) and the time it was drawn up because it does have a time frame it has to be used in. If I need more then the first 100mcg, I'll get a second vial, if I'm really dosing ever 5 minutes Ill use the same syringe... if it's taking longer I'll use a different syringe and place the new time I drew the second vial.

Labetalol comes in a multi dose vial, I only draw what I need for each dose.. again has to be labeled.

Morphine and diluadid come in syringes, so I use the doses I need and waste what ever is left... Because the med and concentration are on the syringe I only need a label with date and time.

[Whitesranch, BSN, RN]

PACU BSN RN CPAN

Illinois/Indiana