liquid narcs

1. I posted this in the wrong spot in geriatrics when i intended to post in general. Anyone had probs with counting liquid narcs (ie phenobarbital) if bottle is 400cc measurement lines are at 10cc increments and there should be 217.4cc how can you tell that is what is actually in there. Some at my facility think we should adjust each time but some of us think it is subjective what do you all think. Any suggestions?
2. 

   About angelbear

   Joined: Dec '02; Posts: 1,055; Likes: 14

   5 Comments

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3. 
   Jan 9, '03

   Occupation: RN.... Joined: Apr '02; Posts: 255; Likes: 6

   with liquid methadone. and actually anything liquid that we don't use the entire bottle of...
   
   mark the bottle with a line and a date and time and initial each time you take out with the actual amt that is suppsoed to bei n there. Sometimes we also use tape to mark it. It is extremely difficult to get an accurate count on those thick liquids.
4. 
   Jan 9, '03

   Occupation: once a manager, now a staff nurse, preceptor, educator and practice member Specialty: 30 year(s) of experience in NICU, PICU, PACU ; From: FAM ; Joined: Mar '01; Posts: 2,797; Likes: 3,172

   We usually just kinda wing it and see if it looks close...it it looks way off then we do a corrected count on the sheet.
   
   Next month they are going to unit dosing on narcs too...we will get prefilled syringes.
5. 
   Jan 9, '03

   Occupation: Endless Joined: Sep '02; Posts: 81; Likes: 1

   We just wing it, and make the adjustment when it is clearly wrong, e.g. when the liquid is at a line, or when the amount seems to be clearly wrong -- 5 ccs or so. I guess we just have to trust each other.
   
   In peds, we can use some extremely small doses and tracking them against the bottle's increments is not possible.
   
   I would welcome unit dosing, but we are having enough trouble getting our pharmacy to deliver boxes of our stock meds, let alone patient-specific stuff. Yikes!
6. 
   Jan 9, '03

   Joined: Jan '03; Posts: 42

   That is how we do it at our LTC facility. We don't actually measure them. We just wing it and guestimate. I mean in all reality, if it is measuring accurately, how do you know that someone didn't water it down? (just a suggestion???) I think you would have to be pretty desperate to be taking liquid roxinal. We have a guy that gets B&O supps. I always say if you are that desperate for a high to steal them, more power to you!!!! Just joking, we are all pretty trustworthy.
7. 
   Jan 9, '03

   Joined: Oct '02; Posts: 1,079; Likes: 53

   WOW!
   I'm cheered to see they still make those B+O supps; really help hospice clients.
   Anyway My personal opinion is this:the DEA has no frigging place at the bedside.
   My professional opinion is this: Scream and yell until you get unit doses. Dont wing trust no one and present it to the managment as a liability/saftey issue and therefore action needed yesterday.

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