There's a shortage of epinephrine emergency syringes, according to an alert from the American Society of Health-System Pharmacists and the Institute for Safe Medication Practices.
The drug's 1mg/10mL (0.1mg/mL) syringes are currently on backorder from their single supplier and will likely remain in short supply until later this summer, says the alert. Until the shortage is resolved, the ASHP and ISMP advise you to notify staff and conserve current supplies of the emergency drug by trying to limit the number of syringes to 2 per code cart.
Even though 1mg/mL injectable epinephrine is still available in 1mL ampules or vials and 30mL vials, the alert cautions against stocking those products in code carts in order to avoid dose miscalculation errors. For example, the drug volume in 30mL vials allows for 10-fold overdoses.
Instead, facilities deciding to use 1mg/1mL ampules or vials of epinephrine in place of emergency syringes should post easy-to-read conversion charts (milligrams to milliliters) where the drug is used and place the vial, diluent, syringe label and mixing directions in a clear plastic bag labeled with the drug name and strength.
According to the alert, epinephrine 1mg/10mL emergency syringes with intracardiac needles are in stock. However, the 3.5-inch needles are incompatible with needleless drug delivery systems, and attempting to remove the needle or using it for intravenous or endotracheal administration could result in harm to the caregiver and patient. To avoid potential mishaps, the alert suggests placing labels on these syringes that warn against removing the needle and note "for intracardiac use only."
Daniel Cook
