Safe Anesthesia Medication Handling

Anesthesia is unique in terms of rapid injection of multiple medications often in a time critical fashion, and it is reported that medication error occurs 1-in-133 administrations. The authors of this Anaesthesia editorial argue for making safe medication handling a core competency in training. They also make several safety suggestions:

Handle one medication at a time.

Avoid distractions while preparing medications.

Check every vial  twice, once before drawing up and once after labelling

All syringes, including iv bags are labelled, ideally with standard colour‐coded labels.

Standard order and syringe sizing for each medication type

Do not draw up medications until they are needed.

Use a red‐barrelled syringe for NMBAs and draw up the whole ampoule into syringe (not available everywhere)  and never reuse a red‐barrelled syringe for reversal; do not place on work surface at the same time as reversal agents

Medications for emergencies, non-IV use, or specific purposes are not kept in the same place as i.v. medications.

All i.v. access points must be flushed or have a running i.v. line before leaving the OR

All medication‐related adverse events must be reported via an incident reporting system.

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