At my current clinical facility, drugs are drawn up in the morning, then locked in the anesthesia cart in the room.  My first day,  I was told to draw up the drugs and even though I’m a nurse, figuring out which syringes they wanted to use slowed me down the first couple times.  Here’s a quick guide to how I draw them up.  It’s best to draw your drugs up in order of what you’ll be using, that way you won’t forget anything.

 Here’s what my normal drug set up looks like:

 

  1. Midazolam – 3 cc syringe
  2. Fentanyl – 10 cc syringe (I used to pull a 3cc, but a majority of the time you will be pulling a 250 mcg vial = 5ml, so have a 10cc syringe handy instead of a 3cc.)
  3. Propofol w/ or without Lidocaine – 30cc syringe (Depending on your facility, they may mix these two.   I generally don’t mix it unless I know the attending wants it that way).
  4. Propofol “oh sh*t sticks” – 10cc syringe: I always have an extra two 10cc syringes of propofol on hand. ALWAYS! 
  5. Lidocaine – 10 cc syringe
  6. Rocuronium or Vecuronium (Prepare powder  with 10cc of sterile water) – 10 cc syringe
  7. Zofran – 3 cc syringe
  8. Decadron – 3 cc syringe
  9. –>  13: pre-filled emergency drugs — succinylcholine, ephedrine, phenylephrine, atropine & lidocaine

 

I start off by taking all of my syringes out and attaching  needles.

I then label my syringes and pull the medication vials.  I double check the medication with the label on the syringe, then draw the medications up.

Date, time & initial at the end.

I also have a flush ready to draw up antibiotics (Depending on the surgeon, I like to see what they’ve ordered first before drawing it up).

I usually prepare syringes for the next case, especially if I am in a high-turnover room.  Remember Propofol is good for only 6 hours after it is drawn up. I try to not be wasteful and take that into consideration!