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Archive December 2020 XXI, No. 12

The Perks of Prefilled Syringes

Predrawn meds are a convenient, safe and economical option.

Danielle Bouchat-Friedman, Associate Editor


Anesthesia Patient Safety Foundation
GRAB AND GO Anesthesia providers who have access to predrawn medications can focus more of their attention on direct patient care.

Buying commonly used medications in premixed, pre-labeled and prefilled syringes should be a no-brainer, right? You'd think so, but ready-to-use syringes are more expensive than traditional medication vials, causing some facilities to avoid stocking the costlier of two options that seemingly serve the same purpose. Look past the initial upfront cost, however, and you'll see prefilled syringes limit waste, increase patient safety and improve overall case efficiencies.

Ready with the right amount

Single-use prefilled syringes come prepackaged in commonly administered doses, meaning providers administer the correct amount of medication without having to waste leftover supplies after cases. Additionally, anesthesia providers must always be prepared with a host of emergency medications. If a patient with a slow heart rate needs to be emergently treated, providers need to have atropine readily available —not in a vial, not in the drawer —and ready to go. "If that medication was in a vial, I'd have to draw it up, put it in a syringe and label it, and it would be good only for an hour," says James Abernathy III, MD, MPH, an associate professor and division chief of cardiac anesthesiology at Johns Hopkins Medicine in Baltimore. "If it's in an unopened prefilled syringe, I can leave the syringe on my cart in case it's needed. If it's not needed, it won't expire." As a result, there's much less medication waste when prefilled syringes are used, which helps justify their cost.

Joyce Wahr, MD, FAHA, vice chair of quality and safety for the department of anesthesiology at the University of Minnesota M Health Fairview, also thinks prefilled syringes reduce waste and therefore can be more cost-effective in the long run.

When Dr. Wahr puts a healthy, young patient to sleep, she draws up a syringe of phenylephrine, in case the patient's blood pressure falls. If the blood pressure remains stable throughout the procedure, she has to throw away the syringe at the end of the case and draw up a new one for the next patient. "A prefilled syringe, however, can stay in the anesthesia cart until its needed," she says. "All I have to do is open a drawer, take off the cap and give it to the patient."

You should also consider the positive impact prefilled syringes can have on staffing expenses. Your medication budget may take a hit on the front end when you purchase prefilled syringes, but labor costs will fall over the long run. "If anesthesia providers spend 15 minutes per case drawing up medications and work six cases a day, that's a lot of time and money," says Dr. Wahr. "Over the course of a year, those minutes and dollars add up."

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