okay guys what we're going to go through is drawing up drugs in anesthesia
and most drugs are really simple to draw up pretty much you just
get the syringe that's about the size of the you know the volume and the amount of
medication you want and then just use either the blunt end of the syringe or a needle or
a puncturing needle to drop your medications for example dexamethasone it's four milligrams in one
mil so really this two or three mil syringe is perfect is i just use a blunt drawing up needle
like that and draw up the medication so most of these ampules what you'll notice is there's
usually a dot on one side so what i do is i get my pointer finger behind that dot and put my thumb on
the dot and then i just push back like this and that opens the vial and some people put a bit of
gauze on there just to prevent you know getting any sharps injuries from there so what i've got
is the appropriately sized syringe and a drawing up needle i can simply draw my medication as
always remember to label all your medications to prevent drug errors and always cap them with a um
stopper as well now other medications come with a rubber stopper especially like this kefazolin
so you might find that you need to puncture that and there's some
really good devices that aren't needles like these and these can puncture really effectively as well
which we'll use later some bars don't even need you to have a needle or any puncturing device
like atropine for example this ampule here simply open that and just plug it into the ampere like so
and drop label and cap what i want to actually go through mostly is some of the most difficult
medications to draw up and two of them two of them that you'll find are kefizolen and other
antibiotics and propofol and just being able to drop these medications efficiently means for
example that if you're an emergency you're really efficient in what you're doing but also you avoid
all the spillage and you know guaranteed i think we all remember our first rotations
in anesthesia we tried to drop kefir zone it just went absolutely everywhere so what i'll do is i'll
just show you my method um so first of all roughly approximately get a 10 mil syringe most patients
will get two grams of this if they're adults if they're over 120 kilos three grams of kefazalen
and it for pediatric cases anywhere from 25 to 50 milligrams per kilogram so 10 ml syringe
i use water for injection you'll find that antibiotics like
ampicillin vancomycin tementing these are much more difficult to draw up and dissolve so
using water really helps and using more water especially in drugs like tementing really helps
i put this particular sharpened drawing up needle and now here's a here's a subtlety to this
the first puncture i make so keep the valve upright puncture the needle into the vial like so
and then using this grip here that you can see i just push all the water in
if i was to do it upside down you'd find that you get a lot of splash back of the water and just get
capsuling everywhere so that's what we do there then i shake to dissolve and this dissolves really
really quite easily now when i'm drying up i have the vial upside down
and i don't over pressurize i just do this with my thumb on the plunger and i slowly drop everything
finally i recap it with that needle
and the kefazin valve as well as labeling this for later same thing i'll just show you in speed
and that's dissolved and then holding the ball upside down just little amounts of air pushed
into the vial enable me to withdraw back on the liquid really effectively
and that's kepazolin one of the most difficult drugs that you'll have to draw up is propofol
and this is really important you know how to draw this up quickly and effectively because it is a
drug you need an emergency so you need it pretty fast it comes in a couple of different vials so
this glass vial here but also a glass file with a rubber cap sorry with a cap and a rubber stopper
like that first of all this one has that red dot there so again pointer finger on the back thumb on
the red dot and just uncap it like so now you can draw this up with one of these drawing up
needles and that's pretty easy to do but i find that this is unnecessary and can be a bit slow
so what i do is i do this technique i have the little nib over here and i simply do this
i just hold my vial and rotate and slowly tilt my syringe as i drop the medication
note that i'm tilting the tilting the vial as i'm completely drying out the solution
and i'll show you that just at speed and what it looks like so breaking the vial
and note that my fingers so i've got thumb on the wings of the of the syringe with the 20 ml syringe
and the rest of my fingers on the plunger so that's my grip and i simply just draw it up i
can draw that really quickly and effectively just like that it's hard getting the last little bits
and you just have to get a bit of practice doing that sometimes you want to run an infusion profile
so you'll find that you use one of these big 50 mil syringes it's got a lower lock connector so
i have to screw that into the m sharpened drawing up needle i uncap the prop fold
now this can be tricky so there's a couple of ways to do this i can plug this in
to the through the rubber cap there and then put a sharp needle so that i don't get an air lock
but i find that's again unnecessary i just need to draw 50 mils of air and puncture that rubber
stopper and then using this grip here because it's a strong grip i can then put most of that
air in and then draw and then it uses the air pressure to draw up my profile like so
fantastic and again i get the air out of the syringe and i just recap that and ready for use
you