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Healing is Coming - February 2021 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Keep in mind that guidelines issued by the American Society of Anesthesiologists say all labels on vials and ampoules must con- tain the drug's generic name, con- centration, total volume or con- tents, manufacturer, lot number, date of manufacturing and expi- ration date. Additionally, providers must note the drug, strength, date and their initials on labels affixed to syringes that will be used in the OR. 7. A patient indicates a "signifi- cant allergy" to Percocet on an admission report. The PRN list for pain management lists sever- al drugs and looks like the example below (the checkmarks indicate the prescriber's endorsed orders). What's your next step? • If the patient cannot take Percocet, administer fentanyl 50 mcg x1; may repeat in 15 minutes one time only • Oxycodone with APAP x1 as needed one time only • Tramadol 50 mg PRN for pain • Acetaminophen with Codeine #3 PRN for pain • Dilaudid 2 mg PO x1 if oxy- codone/APAP is ineffective Answer: Call the prescriber. Oxycodone with APAP is Percocet. If a patient is allergic to Percocet, then oxycodone with APAP is the same thing. "This example reaffirms the need to correlate stated allergies and side effect declarations to endorsed medication orders," says Mr. Sones. 5 0 • O U T P A T I E N T S U R G E R Y M A G A Z I N E • F E B R U A R Y 2 0 2 1 Answer: These various medications need to be separated. Mr. Sones says drug storage areas must not allow for "intermingling" of a number of different agents. The epinephrine vials shown in this photo contain different concentrations, which could lead to confusion when they're pulled for use. Allocating sufficient space for drug storage allows for segregation of each drug and concentration, points out Mr. Sones. He emphasizes that concentrated electrolytes should be stored away from other inventory to help ensure staff are aware the solu- tions need to be diluted before administration. Mr. Sones also says neuromuscular blockers should be stored in separate lidded contain- ers or a secured storage area. Additionally, according to a safety alert issued by the Institute for Safe Medication Practices (ISMP), neuro- muscular blockers should be kept only in areas where they are rou- tinely needed. Warning labels should be placed on their storage con- tainers to alert staff of the risk of respiratory paralysis and the need to ventilate patients who receive them, recommends the alert. OSM 8. How should you address the potential for error shown in this picture? Sheldon Sones

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