Unit-Dose Parenteral Medication Preparation (Vials Ampules and Reconstitution)
Key Points
- Safe preparation requires strict sterility, correct diluent selection, and accurate dose/volume calculation.
- Single-dose vials are discarded after one use; ampules require filter-needle technique.
- Reconstitution must follow manufacturer instructions for diluent type, volume, concentration, and storage.
- Mixing medications in one syringe requires confirmed compatibility and route-specific volume limits.
Equipment
- MAR and active provider order access
- Ordered medication containers (single-dose vial, multidose vial, ampule, or prefilled cartridge)
- Sterile syringe/needle options including filter needle for ampule withdrawal
- Approved diluent and manufacturer/package instructions
- Alcohol swabs, gloves, sharps container, and labeling/documentation tools
Procedure Steps
- Verify patient, order, medication rights, concentration, expiration, and route-specific volume limits.
- Perform hand hygiene and prepare a clean, low-interruption workspace.
- For vials, disinfect stopper, inject air as indicated, and withdraw exact volume with sterile technique.
- For ampules, tap fluid down, cleanse neck, snap away from body with gauze, and withdraw using a filter needle.
- Replace filter needle with administration-appropriate needle before giving medication.
- For powdered drugs, reconstitute using the exact diluent and volume specified by manufacturer/pharmacy.
- Gently mix as directed, verify final concentration, and confirm beyond-use/storage guidance.
- If combining medications in one syringe, confirm compatibility first and keep total volume within route limits.
- For insulin mixing, follow ordered insulin-specific sequencing and never mix incompatible insulin types.
- Label prepared medication per policy, maintain sterility, and proceed to route-specific administration workflow.
- Dispose sharps immediately and document preparation details, dose, route, and response plan.
Common Errors
- Reusing single-dose vials → contamination and infection risk.
- Withdrawing from ampule without filter needle → particulate contamination risk.
- Wrong diluent or wrong reconstitution volume → unsafe concentration and dose errors.
- Mixing incompatible medications or excess volume → precipitation, pain, or poor absorption risk.
Related
- intradermal-medication-administration - ID-specific limits and technique constraints after preparation.
- subcutaneous-medication-administration - SQ route volume/angle requirements.
- intramuscular-medication-administration - IM site and volume decisions for prepared doses.
- intravenous-medication-administration-safety - IV compatibility and monitoring requirements.
- sharps-disposal-and-needlestick-response - Required sharps safety during preparation and administration.