Help me understand an Ampule

[Femine91]

As the title suggests, I have not yet had to administer an ampule. Im an early grad and so still have key questions on concepts so please bear with me. In school, we were given only one demo and one practice. I have had questions since then which my instructor brushed off (I sensed she felt I asked too many questions, but I can guarantee you that I spoke for my peers who were too afraid to ask "dumb questions")

Well here it is:

Why is an ampule contained in an "ampule"? Why not just a regular vial? Why go through the whole process of breaking tip, using filter needle, inverting, with the very possibility of spilling the whole medication and wasting it. Why cant a regular vial just do?

What if...I draw from an ampule without inverting it? What difference does it make? I have to administer a medication to my mom tomorrow involving an ampule, I confidently told her that I could do it, but deep down this nagging question and fear comes along...what if i screw it up and spill her medication? Shell never forgive me!

Fellow nurses, thanks in advance!

[amoLucia]

Back in the Dark Ages (when I was a new nurse) a metric butt ton of meds came in ampules. Hated them then, hate them now.

That said- they ARE tamperproof.

Lasix brand Lasix used to come in an amp and it was IV pushed like water 'in the ole days'!

Dilaudid and mag SO4 (both orange print on the glass) were also amps. Aminophylline, KCl and berocca.

I didn't flick the amp - you could do the grand old 'around the world arm swing'.

WOW!!! Trip down memory lane!

[Val_RN]

In school we were allowed to practice drawing up from an ampule and were told to invert it when drawing up the meds and it didn't spill. I was so amazed by that:eek: I don't quite understand how it works but it does!

[TheCommuter, BSN, RN]

i don't invert ampules to draw up the med. I also use a couple alcohol wipes (still in the wrapping) to break the ampule. Break away from you but not in someone's face..

I use an alcohol wipe and ensure both hands are gloved. I've had the unpleasant experience of being cut when breaking an ampule with gloved hands only.

The wipe serves as an extra barrier of protection for my fingers.

[nursej22, MSN, RN]

I learned to tear off the end of the foil alcohol packet and slide that over the top of the ampule to break it.

i have had liquid leak out of bigger ampules, like 5 cc metoprolol and morphine PF that we used to inject into epidurals.

Here's a flashback to 30 years ago: Demerol in a pre-filled carpujet, with a needle already attached. Draw up Vistaril into the Demerol, then inject into a syringe and attach a new needle, minimizing the Vistaril burn on insertion. Demerol and Vistaril IM, q 3-4 hrs prn post-op pain, no PCAs.

[Spidey's mom, ADN, BSN, RN]

I learned to tear off the end of the foil alcohol packet and slide that over the top of the ampule to break it.

i have had liquid leak out of bigger ampules, like 5 cc metoprolol and morphine PF that we used to inject into epidurals.

Here's a flashback to 30 years ago: Demerol in a pre-filled carpujet, with a needle already attached. Draw up Vistaril into the Demerol, then inject into a syringe and attach a new needle, minimizing the Vistaril burn on insertion. Demerol and Vistaril IM, q 3-4 hrs prn post-op pain, no PCAs.

I remember that!! Those baby blue Carpujects. (Hey, look what I found when googling how to spell Carpuject!)

https://allnurses.com/nursing-patient-medications/confused-about-carpuject-626713.html

[nursej22, MSN, RN]

Oh, I forgot about Tubexes, I think they had the attached needles, and we had metal holders for them.

[bgxyrnf, MSN, RN]

My favored means of opening an ampule was with a certain kind of filter needle stocked at one place. They came in green plastic shells. When you opened the shell, one end fit perfectly over the tip of the ampule and well protected my fingers.

Regarding inversion, I see no practical benefit and I do not.

[txbornnurse]

I cannot for the life of me remember this one medication that came in an ampule that had a teeny-tiny file in the package to file the ampule tip off. Using that puppy was the only time I ever cut myself opening an ampule. Dang file was sharp :).

I have always had pretty good hand strength and I remember more than once I actually crushed the main portion of the ampule in the process of opening them. A sort of Rocky and Bullwinkle moment of "I don't know my own strength!"

[amoLucia]

Tubex meds used to have different color rubber-y syringe end sheaths/needle caps. Red and blue ones. I think the red ones were for narcotics; blue for non-narcs.

I had a really sick youngun' (late teens? early 20s-ish?) who really liked his Demerol. He knew what color was for which med, so unless it had the RED cap, he didn''t want the med.

Sorry for the thread hijack!

[Kooky Korky, BSN, RN]

I once pulled a phenergan ampule that ended up not being used, and slipped it into my pocket, where I promptly crushed it against a bed rail while repositioning a patient. I smelled like a chemical factory and I had a pocket full of glass. It was not fun.

All the important info has been covered, so I'm just spreading the hate

I'm in the "don't invert" crowd.

I've inverted many, no ill effects.

You can also draw med out of the top of the ampule, not just from the lower part of the ampule.

[Kooky Korky, BSN, RN]

Oh, I forgot about Tubexes, I think they had the attached needles, and we had metal holders for them.

Except when we didn't have either metal or plastic holders for them. These were very hard to come by, as Pharmacy either didn't provide them regularly or nurses would hoard them privately. Frustrating. More than once I've had to draw out the med from the Tubex and give it with a regular syringe.

[NOADLS]

Have we really sunk this far down that we are trying to "understand" an ampule? An ampule is an inanimate object which does not feel anything.

The social justice warriors really need to be reality checked here. What's next? What if the ampule identifies as a vial, but still has the physical properties of an ampule? Forgive me for not understanding the poor ampule better. Those poor marginalized ampules. What have I done?