Wednesday, January 4, 2017

Trick of the Trade: Quick & Painless Ampule and Filter Needle Technique

Standard technique for transferring a medication from a glass ampule involves swabbing the ampule with isopropyl alcohol and breaking the neck of the ampule with the alcohol pad or gauze. The problem that many can attest to is the glass breaking in a way that punctures through the pad or gauze and cuts into one’s digits.
Not only is this a painful issue, but there are other considerations when a member of the team cuts themselves: leaving the bedside, hemostasis, glove replacement, potential need for a new ampule, infection, and a focus change from the patient's needs to yours.
Ampule assortment of commonly used medications in emergency medicine

TRICK OF THE TRADE

Avoiding glass in your finger(s) when using a filter needle
video

Detailed step-by-step instructions:
1. Pull a syringe, alcohol pad, and filter needle. Quickly swab the neck of the ampule.
Keep the syringe and needle aseptic and not on a counter

2. Attach the filter needle to the syringe and place the bottom cap of filter needle on to the top of the ampule. Break neck with hands away and out from you. Withdraw the solution from ampule.
Note: Never inject medication back through the filter needle after withdrawing from a glass ampule.

This trick of the trade works for almost every ampule size and may take a few attempts to optimize the aseptic components of the technique (see video above). 

Mark Culver, PharmD, BCPS (@EMdruggist)
Emergency Medicine Pharmacist
Banner - University Medical Center Phoenix
Phoenix, Arizona

Peer reviewed by Nadia Awad, PharmD, BCPS (@Nadia_EMPharmD)