Transcript Chapter 4
Chapter 4 Medication Administration Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Roles Describe the role of the Surgical Technologist / Anesthesia Technician in medication administration. Circulator / Anesthesia Tech First scrub (STSR) Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Roles: Circulator / Anesthesia Tech Obtain medications. Identify medications. Deliver medications. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Roles: Circulator / Anesthesia Tech Maintain asepsis during delivery to sterile field. Document medications. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Roles: STSR Accept medications. Identify medications. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Roles: STSR Label medications immediately. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Roles: STSR Pass medications. Say the name of drug clearly when passing it to surgeon. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. “Rights” of Drug Administration Explain the 6 “Rights” of medication administration. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. #1: Right drug Read preference card and medication label carefully. (From Morris DG: Calculate with Confidence, 3rd ed, St. Louis, Mosby, 2002) Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. #1: Right drug Say drug name when handing to surgeon. Keep vials in room. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. #1: Right drug CAUTION: Some drugs sound alike or are spelled alike. For example: Pitocin/pitressin Epinephrine/ephedrine Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. #2: Right dose Correct amount (volume) Correct strength (concentration) 30 ml 1%, 2%, 0.5% The right dose is the amount multiplied by the strength. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. #2: Right dose Vital when mixing medications on back table Vital when multiple strengths of the same medication are on back table Label each medication carefully. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. #3: Right route Surgeon administers medications at the surgical site. Surgeon determines route. STSR role in right route Correct formulation of drug Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. #3: Right route For example, epinephrine Strength for topical is 1:1000 Strength for injectable is 1:100,000 Both are clear solutions. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. #3: Right route/CAUTION! You must know the route and purpose for different epinephrine strengths. A mix-up can cause patient death. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. #4: Right patient Identify patient. Verify surgeon and procedure. Check preference card. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. #5: Right time Per verbal order Surgeon administers medications at the surgical site at the intended time. What was #6? Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Identification Describe the steps of medication identification. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Medication ID steps Read label when obtaining drug. Check integrity of container. Circulator reads label to STSR. Anesthesia Tech reads label to Anesthesiologist Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Medication ID steps Circulator shows label to STSR. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Medication ID steps STSR repeats information. Medication is delivered to field. Medication is labeled. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Medication ID steps Warning: Do NOT accept any medication onto your back table without reading the label first. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Delivery Discuss aseptic techniques for delivery of medications to the sterile field. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Asepsis/delivery Vials: Do NOT touch rubber stopper. • Wipe with alcohol swab Do NOT touch syringe plunger. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Asepsis/delivery Vials: pouring Remove stopper without touching lip of vial. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Asepsis/delivery Vials: pouring Pour away from area where stopper removed. • Label up Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Asepsis/delivery Vials: pouring, vial decanter Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Asepsis/delivery Vials: pouring Or hold vial inverted (away from table) for STSR to draw up. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Asepsis/delivery Ampules Protect hands when breaking ampule. Break away from face. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Asepsis/delivery Pour bottles Cap up and off Empty all contents at once. Do NOT recap. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Asepsis/delivery Circulator should NOT lean over sterile back table to deliver medications. STSR should hold medication container out away from back table for circulator. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Labeling State the procedure for labeling drugs on the sterile back table. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Labeling All medications must be labeled immediately after accepting from the circulator! Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Labeling Label intermediate container Med cup, pitcher, basin Label administration item Syringe Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Labeling options Preprinted labels Write drug name and strength with skin marking pen on Blank label Skin adhesive strips Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Labeling NOTE: Failing to label all medications on the sterile back table is unacceptable practice and probable negligence. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Supplies Identify supplies used in medication administration in surgery. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Supplies Intermediate containers Pitchers, basins Med cups Petri dishes Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Supplies Administration items Syringes Parts of a syringe Sizes and tips Types of syringes Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Supplies Administration items Hypodermic needles Parts of a needle Gauge and length Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. In summary The surgical technologist’s role in medication administration in surgery is VITAL! The anesthesia technician’s role in medication administration in anesthesia is VITAL! Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. In summary The ST Identifies medications Labels medications Passes medications All must be correct. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc.