How do you draw up meds for IVP?

[FineAgain]

I am curious...how do YOU draw up meds for IVP? For instance, if you have a vial of 1 mg/1ml of dilaudid, and you only want to give 0.4 mg/0.4 mL...how do you draw it up? I have seen nurses use a 3 mL syringe to draw up the 0.4 mL, the inject it into a NS flush; I have also seen nurses draw up the med, and inject it into a 10 mL syringe, change needles and draw NS into the syringe to mix it.

As a new med-surg nurse, I am curious as to what you consider best practice. I have looked online for information on this and find that practice varies there too!

[IVRUS, BSN, RN]

The fluid inside a prefilled syringe is sterile, but if the syringe is only packagd in a dust cover then only the solution is sterile, and thus the reason that it can't be placed onto a sterile field. If however, the entire syringe has been sterilized, then it will NOT be in a flimsy package, or dust cover and it will say sterile on it.

[Do-over, ASN, RN]

EBP aside, the main problem I have with injecting a medication into a flush is that it would seem to increase the risk for an error. Are the barrels of these flushes being labeled immediately? How are the flushes recapped after the med is injected? Do you ever put meds in your pocket? (Ex. draw up meds, on the way to that patient there is an urgent need somewhere else - pop meds in pocket...)

[FineAgain]

I have made it part of my routine to label anything I draw up. Prevents mistakes if I have to run off and put it in my pocket. I cap them with a red cap -- easy and secure. I try not to use flushes but to draw up sterile saline from a vial. Sometimes we have no choice if the med is urgent and there is no saline.