Vial Overfill

[winds022]

Do most single-dose medication vials contain the amount of volume listed on the label or is there some overfill?  For example, the vial can say 1 mL, but the amount of liquid in the syringe will read more than 1 mL (even with low dead space).  I once asked a nurse why she was drawing up more than the required dose of 1 mL of a medication and she said, "because the label says there is 1 mL in the vial."  

[chare]

If the nurse you refer to is actually drawing up the entire volume vial "because the label says there is 1 mL in the vial," she is in desperate need of remedial education.

Most, if not all, medications vials contain a small amount of overfill.

[londonflo]

1 hour ago, winds022 said:

because the label says there is 1 mL in the vial."

Guess she missed the info on the label: ___ mg = 1 ml and continued to draw up until the vial was empty.  This just proves "nature abhors a vacuum" in his/her brain. (I do understand I am not using Einstein's phrase correctly)

Also guess she/he missed with controlled drugs they are usually supplied 'pre drawn up' no extra there.

[chare]

10 minutes ago, londonflo said:

Guess she missed the info on the label: ___ mg = 1 ml and continued to draw up until the vial was empty.  This just proves "nature abhors a vacuum" in his/her brain. (I do understand I am not using Einstein's phrase correctly)

[...]

While this works, I think the old adage "Better to remain silent and be thought a fool than to speak and to remove all doubt" is appropriate as well.  Either way, it is somewhat scary that she isn't able to correlate what she actually has in her syringe.

17 minutes ago, londonflo said:

[...]

Also guess she/he missed with controlled drugs they are usually supplied 'pre drawn up' no extra there.

Not necessarily.  Where I work I find that many of our commonly used controlled substances (fentanyl, 50 mcg/1mL vial; ketamine, 30 mg/3 mL prefilled syringe, and midazolam, 2 mg/1 mL vial) all have a small amount of overfill.

[londonflo]

6 minutes ago, chare said:

, I think the old adage "Better to remain silent and be thought a fool than to speak and to remove all doubt" is appropriate as well. 

Are you referring to me?

[chare]

27 minutes ago, londonflo said:

Are you referring to me?

Of course not, I was referring to the nurse you addressed with the vacuum comment.  I have always liked Mr. Lincoln's quote and use it whenever I have opportunity.

And if my post read that way, my apologies.

[londonflo]

1 hour ago, chare said:

  I have always liked Mr. Lincoln's quote and use it whenever I have opportunity.

And if my post read that way, my apologies.

Yes your post read that way to me and I accept your apology. But, I still do not understand where your quote from Lincoln/Twain/ Switzer fits into the discussion

 

1 hour ago, chare said:

"Better to remain silent and be thought a fool than to speak and to remove all doubt" is appropriate as well.

"Better to remain silent and be thought a fool than to speak and to remove all doubt," has been wrongly attributed to Abraham Lincoln, Mark Twain but is by Maurice Switzer 

Quote

“It is better to remain silent at the risk of being thought a fool, than to talk and remove all doubt of it.”
― Maurice Switzer, Mrs. Goose, Her Book

1 hour ago, chare said:

Where I work I find that many of our commonly used controlled substances (fentanyl, 50 mcg/1mL vial; ketamine, 30 mg/3 mL prefilled syringe, and midazolam, 2 mg/1 mL vial) all have a small amount of overfill.

The above is where You work. Not all floors/units have the same supply - it depends on what is commonly used. A general medical/surgical floor does use any of the above drugs you cited.

 

 

[chare]

9 minutes ago, londonflo said:

2 hours ago, chare said:

Where I work I find that many of our commonly used controlled substances (fentanyl, 50 mcg/1mL vial; ketamine, 30 mg/3 mL prefilled syringe, and midazolam, 2 mg/1 mL vial) all have a small amount of overfill.

The above is where You work. Not all floors/units have the same supply - it depends on what is commonly used. A general medical/surgical floor does use any of the above drugs you cited

Agreed.  However, the quote I responded to was regarding controlled substances.

2 hours ago, londonflo said:

[...]

Also guess she/he missed with controlled drugs they are usually supplied 'pre drawn up' no extra there.

No mention here of acute care vs. critical care.  However, at my facility both fentanyl and midazolam are both stocked in the Pyxis on the children's hospital acute care floors.

14 minutes ago, londonflo said:

Yes your post read that way to me and I accept your apology. But, I still do not understand where your quote from Lincoln/Twain/ Switzer fits into the discussion.

[...]

From the OP:

3 hours ago, winds022 said:

... I once asked a nurse why she was drawing up more than the required dose of 1 mL of a medication and she said, "because the label says there is 1 mL in the vial."  

Had I seen this, I would have thought this was potentially foolish, although she could have potentially expelled the excess volume after administration.  However, with her comment it became clear she was a fool.