Removing Medication from an Ampule

Goal: The proper dose of medication will be removed in a sterile manner, and will be free from glass shards.

1. Gather equipment. Check the medication order against the original order in the medical record, according to facility policy. Clarify any inconsistencies. Check the patient’s chart for allergies.

2. Know the actions, special nursing considerations, safe dose ranges, purpose of administration, and adverse effects of the medications to be administered. Consider the appropriateness of the medication for this patient.

3. Perform hand hygiene.

4. Move the medication cart to the outside of the patient’s room or prepare for administration in the medication area.

5. Unlock the medication cart or drawer. Enter pass code and scan employee identification, if required.

6. Prepare medications for one patient at a time.

7. Read the CMAR/MAR and select the proper medication from the patient’s medication drawer or unit stock.

8. Compare the label with the CMAR/MAR. Check expiration dates and perform calculations, if necessary. Scan the bar code on the package, if required.

9. Tap the stem of the ampule or twist your wrist quickly while holding the ampule vertically.

10. Wrap a small gauze pad around the neck of the ampule.

11. Use a snapping motion to break off the top of the ampule along the scored line at its neck. Always break away from your body.

12. Attach filter needle to syringe. Remove the cap from the filter needle by pulling it straight off.

13. Withdraw medication in the amount ordered plus a small amount more (approximately 30% more). Do not inject air into the solution. Use either of the following methods. While inserting the filter needle into the ampule, be careful not to touch the rim.
a. Insert the tip of the needle into the ampule, which is upright on a flat surface, and withdraw fluid into the syringe. Touch the plunger at the knob only.
b. Insert the tip of the needle into the ampule and invert the ampule. Keep the needle centered and not touching the sides of the ampule. Withdraw fluid into syringe. Touch the plunger at the knob only.

14. Wait until the needle has been withdrawn to tap the syringe and expel the air carefully by pushing on the plunger. Check the amount of medication in the syringe with the medication dose and discard any surplus, according to facility policy.

15. Recheck the label with the CMAR/MAR.

16. Engage safety guard on filter needle and remove the needle. Discard the filter needle in a suitable container. Attach appropriate administration device to syringe.

17. Discard the ampule in a suitable container.

18. Lock the medication cart before leaving it.

19. Perform hand hygiene.

20. Proceed with administration, based on prescribed route.