Techs and MEDS?????

[RNOTODAY]

Hi all, I have a question. I "shadowed" today at a large univ. hospital OR. This is a new field for me, I have done ER in the past. But something struck me as odd. The circulator, pours meds into a sterile cup, and the scrub tech goes back to the field with the meds, and the circulator has no more control of it, but yet is responsible for it? It strikes me as weird that an unlicensed person would even be touching meds as important as EPI, Marcain, etc. The cups were not even labeled, but even if they were, can it really be left to the techs to not mix them up? Can someone clear this up for me? Any thoughts? Opinions? I am assuming that is how it is done, not that anyone was doing anything improper, (besides the not labeling)....but.... I am just not used to giving up meds to someone who is not trained to handle them......

[Marie_LPN, RN, LPN, RN]

Didn't I say that the biggest problem was that the cups were unlabeled???

You never mentioned that they were drawing up doses later on in your original post. You just said they were transporting the meds from circulator to the field, nothing about drawing anything up.

"Drawing it up" from the cup, into a syringe.

[Marie_LPN, RN, LPN, RN]

Sometimes the lymphazurine is drawn straight from the vial.

[Gompers, BSN, RN]

"Drawing it up" from the cup, into a syringe.

I'm saying that she never mentioned in her first post that after the circulator put the med in the cup, that the tech was not only transporting it to the field, but also drawing it up for administration. I never saw those words. I just read that the tech took the med from the circulator to the field, period. I assumed the tech was giving the meds to anesthesia, who then drew up and administered the meds. I suppose it really doesn't matter who does what - the problem remains that it is so stupid to not label those cups!

I'm sorry I'm so touchy this morning. I'm trying to wind down from a PM/NOC double shift where the you-know-what hit the fan on our unit.

[Marie_LPN, RN, LPN, RN]

I assumed the tech was giving the meds to anesthesia, who then drew up and administered the meds.

Usually the ones in the cups are things like Lidocaine 1% (with or without epi), Marcaine (with or without epi), local anesthetics. They're typically drawn up in a 10 ml syringe, and handed to the surgeon, who injects around the incision site, usually for help in pain relief post-op.

Conray is another, mixed with bacteriostatic water sometimes, or it's used full strength, for x-raying.

If anesthesiologist needs something drawn up, they either do it themselves, or the circulator does it, not a tech.

I hope that helps.

[Marie_LPN, RN, LPN, RN]

Also, Heparin and IV Saline mix (5,000 units of heparin in 500 mls of saline) are sometimes used as a flush/irrgation during vascular procedures, either 20 ml syringes, or 10 ml syringes usually).

[Marie_LPN, RN, LPN, RN]

All that said, i don't care if it's sterile WATER, EVERYTHING should be labeled! And that really applies to every dept.:)

[RNOTODAY, BSN, RN]

Where i work, you have to be an LPN or an RN to handle meds. This include pour onto the sterile field, or working with it on the sterile field (even though it's the surgeon administering it).

As for the unlabeled cup, i refuse to accept a med on the field till i make a label for it if it's not an emergency. If i think a med might be used, i'll make labels ahead of time, that way when a surgeon asks for something out of the oridinary, I already have my cup labeled by the time the circulator has the med ready to pour.

Unlabeled cups, basins, or syringes is EXTREMELY dangerous.

I knew I wasnt being rediculous..... thanks for responding.... the way you do it makes MUCH more sense,,,, but this place has many many scrub techs in their OR. Are you on the east coast, may I ask?

[RNOTODAY, BSN, RN]

Didn't I say that the biggest problem was that the cups were unlabeled???

You never mentioned that they were drawing up doses later on in your original post. You just said they were transporting the meds from circulator to the field, nothing about drawing anything up.

Sorry!!! Yes, they were being drawn up at the field by the tech. (from the cups the circulator put them in)

[Marie_LPN, RN, LPN, RN]

East coast, yes.

I mena, it was over things like labeling as to why scrub techs where i work are not allowed to work with any meds anymore.

[RNOTODAY, BSN, RN]

East coast, yes.

I mena, it was over things like labeling as to why scrub techs where i work are not allowed to work with any meds anymore.

I think thats how it should be. This is a big OR, I think around 30 rooms, open hearts.. etc... but they said they are training the new pwople to circ and scrub. But my time there , I only saw the techs scrub, and the nurses circulate. Is this how it is pretty much all over? (st's scrubbing, and nurses circulating)

[Marie_LPN, RN, LPN, RN]

Only RNs are permitted to circulate in ORs.

[RNOTODAY, BSN, RN]

Only RNs are permitted to circulate in ORs.

Yes, I mean is it the norm to have mainly St's (not nurses) to scrub?