Vial Medication Administration: How to Withdraw Vial Medication Nursing Skill

Summary

In this tutorial, Sarah from RegisteredNurse.com demonstrates how to properly withdraw medication from a vial. The video covers essential steps, including preparing supplies, maintaining cleanliness, and safely withdrawing medication using the right syringe and needle techniques. Sarah explains the importance of air injection to prevent vacuum formation, the proper angle for inserting the needle, and how to check for air bubbles. She emphasizes the need to replace the needle before administering the medication to avoid patient discomfort. This video is a valuable guide for nursing professionals to ensure safe and efficient medication preparation.

Takeaways

• 😀 Always check the physician's order and confirm the correct medication and dosage before starting.
• 😀 Gather all necessary supplies including the vial, syringe of appropriate size, alcohol prep pads, vial access device, and an extra needle for administration.
• 😀 Perform proper hand hygiene before handling any medication or supplies.
• 😀 Attach the vial access device securely to the syringe to prevent loosening during withdrawal or administration.
• 😀 Clean the vial stopper with an alcohol prep pad for at least 30 seconds and allow it to dry completely to reduce contamination risk.
• 😀 Draw air into the syringe equal to the volume of medication to be withdrawn and inject it into the vial to prevent a vacuum.
• 😀 Use the proper technique when piercing the vial stopper: center of the bullseye, bevel up, 45° angle, then rotate to 90° smoothly.
• 😀 Withdraw the prescribed amount of medication, checking for and removing any air bubbles before confirming the dose.
• 😀 Always replace the needle used for withdrawal with a new needle before administering to the patient to prevent contamination or dullness.
• 😀 Perform hand hygiene again before administration and double-check all steps to ensure patient safety.

Q & A

Why is it important to follow both employer guidelines and drug manufacturer recommendations when withdrawing medication from a vial?

Following both ensures safe medication handling, accurate dosing, and compliance with legal and institutional protocols, reducing the risk of contamination or errors.

What factors determine the size of syringe to use for medication withdrawal?

The syringe size depends on the volume of medication being administered. For example, 2 mL of medication is withdrawn using a 3 mL syringe to ensure proper handling and accuracy.

Why do you need a separate needle for administering the medication?

The original needle may be dulled or contaminated after penetrating the vial stopper, which could cause discomfort or introduce contaminants when injected into a patient.

What types of vial access devices can be used, and why might you choose one over another?

Options include a plain needle, blunt tip fill needle, or filter needle. Blunt tip needles reduce needlesticks, while filter needles prevent glass or particulate contamination when withdrawing medication from ampules or reconstituted powders.

Why is it necessary to clean the vial stopper with an alcohol prep pad before withdrawing medication?

Cleaning the stopper for 30 seconds decreases the risk of contamination entering the vial and ensures the medication remains sterile.

What is the purpose of injecting air into the vial before withdrawing medication?

Injecting air prevents a vacuum from forming inside the vial, making it easier to withdraw the correct volume of medication and avoiding potential dosage inaccuracies.

How do you properly insert the needle into the vial to prevent 'cing'?

Position the needle at the center of the stopper (bullseye) at a 45° angle, bevel up, then rotate to 90° while inserting in one smooth motion. This prevents rubber fragments from entering the vial.

How do you handle air bubbles that appear in the syringe after withdrawing medication?

Lightly flick the syringe barrel to move air bubbles into the airspace, then ensure the plunger aligns with the correct measurement to maintain accurate dosing.

Why is it critical not to touch the plunger shaft or syringe tip?

Touching these areas can contaminate the syringe, increasing the risk of introducing pathogens when administering medication to a patient.

What steps should be taken immediately before administering the medication to the patient?

Perform hand hygiene again, attach a new needle for administration, double-check the medication and dosage, and ensure everything is prepared safely according to protocol.

What considerations should be made when using a filter needle or blunt tip needle?

Check facility protocols and manufacturer guidelines, as some medications require filter needles to remove particles or blunt needles to reduce needlestick risk during preparation.