Nurses Pre-Mixing and Storing Lidocaine


I was recently told that we are no longer allowed to do this in our Emergency Room.

The old practice was each morning, the nurse would add 2ml Sodium Bicarbonate to a 20ml vial of 1% Lidocaine, then draw up about 20 3cc syringes with the buffered lidocaine. Then a label was added that stated the contents, nurses initial, time and date. The pre-filled buffered lidocaine syringes would be put away in a locked cabinet for later use by a PA/NP/MD. The unused syringes discarded after 24 hours.

I am not sure why the nurses cannot do this anymore. It is very frustrating now because you must buffer a new vial everytime, and discard the vial after one use even if 3cc was used. We are going through 15-20 vials of Lidocaine a day and always run out of Lidocaine AND Sodium Bicard in the Pyxis (our pyxis hold 4 60ml vials of bicard (only 2 mLs is used and then thrown away --what a waste!) and about 10 lidocaine vials).

What are your thoughts on this?

We were told we couldn't do it anymore because it was out of our scope of practice, that mixing/labeling meds for later use by somebody else is something only a pharmacist can do.

Sorry for the length post, thanks!

Specializes in intensive care major medical centers.

i guess you are using this for preinjection to start iv's??????

a poke is a poke dont need it

mamamerlee, LPN

949 Posts

Specializes in home health, dialysis, others. Has 35 years experience.

1. What is this used for?

2. It would be the pharmacist's job to do this.


45 Posts

Specializes in Emergency.


The MDs/PAs/NPs use this for local anesthetic pre-suturing or I&D

Specializes in intensive care major medical centers.

it a money thing the hospital is charging for the vial to each patient which I think is ok, and it a time thing the dr,pa,and np can draw this up their selfs and pharmacy will have to change ther par levels if more is needed so in short I dont see what the fuss is (sorry!)


66 Posts

Has 1 years experience.

That does sound like a huge waste of time, money, and materials! No wonder healthcare costs continue to skyrocket.

I don't see why the pharmacy doesn't just mix them up, lebel them, and then stock them. If it is decided it is out of the nurse's scope of practice, thats fine. But it sounds like they either need to re-evaluate their procedure or order some smaller dose vials!