When preparing an injection from an ampule what will the nurse do if liquid is trapped in the neck of the ampule?

Learn how to withdraw medication from a glass ampule!

As a nurse you will encounter some medications that are supplied in a glass ampule, and you will need to know how to break open the glass ampule and withdraw the medication from it.

Also check out how to withdraw medication from a vial.

Demonstration on How to Remove Medication from an Ampule

After confirming you have the:

1. right medication
2. right dose
3. at the right time
4. via the right route for…
5. the right patient.

Gather your supplies and perform hand hygiene. You will need the following:

• A syringe to withdraw the medication with a non-filtered needle or needleless device to administer the medication.
• A filter straw or needle to help filter out any small glass pieces that may have entered the solution so you won’t inject them in the patient when you administer the medication.
  
  • Filter straws come in various lengths (example: 4” to 1 ¾), so pick the correct size based on the size of the ampule.
• Gauze to help you break the ampule.
• Alcohol prep to help you clean the outside of the ampule before breaking it.
• Ampule of medication

1. Inspect the ampule for any damage, discoloring of solution, or particles in the solution.
2. Make sure the liquid in the ampule is all collected in the body of the ampule rather than the head and neck.
   1. To do this: lightly tap on the head of the ampule and it will drip down into the body of the ampule.
      
3. Clean the neck of the ampule with alcohol prep and let it dry.
4. Connect the syringe to the filter straw (leave it in the protective packaging until you’re ready to use it) and leave the syringe’s needle in the protective packaging until ready to use as well.
   
5. Take the gauze and wrap it around the head and neck of the ampule.
6. Sit the ampule on a flat sturdy surface and pull on the head of the ampule in a snapping motion to break off the head of the ampule at it’s neck…most ampules have a scored neck so they are easy to break off.
   
   1. NOTE: Pull the head off so the broken parts of the ampule are AWAY from your body/hand when it breaks. This will help prevent injury to yourself.
      
7. Discard the head of the ampule into the sharps box (or however your facility requires).
8. To withdraw the medication from the ampule:
   1. Place the ampule on a flat sturdy surface.
   2. Insert the filter straw into the ampule (don’t touch the edges of where the ampule is broken because it’s contaminated). Also, do NOT inject air into the ampule…this is only applicable to vials.
   3. Withdraw the amount of medication ordered. You will want to withdraw a little bit more than ordered because you will have to remove the extra air out of the syringe, and then you can squirt out the excess.
      
   4. Remove the filter straw from the ampule and turn the syringe upward and remove any air bubbles by flicking the syringe and using the plunger to push out the air bubbles.
      
   5. Remove and discard the filter straw and ampule in the sharps container (or as your facility requires).
      
   6. Attach the syringe’s original needle device and keep it in the protective covering until ready to use.
      

You may be interested in more nursing skills.

Safety

• Ensure that the Six Rights of Medication Administration are followed: right medication, right dose, right patient, right route, right time, and right documentation.
• To protect your fingers, place a small gauze pad or unopened foil-wrapped alcohol swab around the neck of the ampule when snapping it open. Do not use an opened alcohol swab to wrap the top of an ampule, because alcohol may leak into the ampule.
• Use a filter needle or filter straw to withdraw medication from an ampule, so that glass particles cannot enter the syringe.
• When using a filter needle/straw, remove or replace it with a needle of the appropriate gauge and length for the injection.
• Use strict asepsis when preparing an injection from an ampule.
• Establish a “No Interruption Zone” when preparing medications.

(Roll cursor over items to see labels)

Filter needle or filter straw

SESIP safety needle for injection

Tape for labeling syringe

List

The skill of preparing an injection from an ampule or vial may not be delegated to nursing assistive personnel (NAP).

Preparation

• Check the accuracy and completeness of each medication administration record (MAR) against the health care provider’s medication orders. Confirm the patient’s name, medication name, dosage, route of administration, and time of administration. Clarify incomplete or unclear orders with the health care provider. Note if the patient has allergies.
• Observe the Six Rights of Medication Administration: right medication, right dose, right patient, right route, right time, and right documentation. (For details, see the Video Skill “Ensuring the Six Rights of Medication Administration.”)
• When drawing up medication for injection away from the patient’s bedside, be sure to label the syringe with the name of the medication and the amount it contains.
• Review the medication reference information for action, purpose, side effects, and nursing implications.
• Assess the patient’s body build, muscle size, and weight if giving subcutaneous or intramuscular medication.

Follow-up

• Just before administering the drug to the patient, compare the MAR with the label of the prepared drug, and compare the dose in the syringe with the desired dose.

Record medication administration after giving the drug. It is not necessary to document medication preparation from an ampule separately.