Introduction to the Operating Room
LESSON 3: Safety in the Operating Room
3-12
3-12. THE IDENTIFICATION AND USE OF DRUGS
a. Discussion. The improper identification, administration, or use of drugs may endanger the life of a patient. This improper handling of drugs includes such hazards as giving a patient a wrong drug, giving an inaccurate dosage of the right drug, and failing to take appropriate precautions when extremely dangerous drugs (such as phenol and cocaine) are to be used. The specialist may avoid such errors by following the safety rules set forth below.
b. Reading the Label. The specialist preparing the drug should read the label on the vial, ampoule, or bottle three times--when taking the drug from its storage place, when ready to pour or withdraw the drug, and just before either discarding the drug container or returning it to its storage place. If the drug is handed to another person (such as the scrub or doctor), then that person should be shown the label also. The specialist is never to use a drug that has changed color or one from an unmarked or poorly labeled container.
c. Pouring the Excessive Amount of Drug. If the specialist pours or withdraws an excessive amount of a drug, he is to discard the excess drug. He is not to return it to the supply container.
d. Drugs for Use Within the Operative Area. The label of a drug prepared for use within the operative area is to be checked by two persons. In addition, the specialist states the name of the drug when handing it to the surgeon.
e. Use of Cocaine. Cocaine must be kept in a locked place and must be accounted for, since it is classed as a narcotic agent. Cocaine is a highly toxic drug, and therefore, the following precautions should be observed in its use.
(1) Cocaine solution should be stored in a dark bottle away from light and never for duration longer than 2 weeks. The length of storage time will depend upon the surgeon. Many medical officers prefer a freshly made solution each time it is used for topical anesthesia.
(2) Cocaine is never to be injected. It is used for topical anesthesia only.
(3) Dosage should be checked carefully. Cocaine is supplied in ampoules containing either 3.5 g or 0.5 g of the drug and is usually used in solutions of two, four, and ten percent.
(4) Personnel who prepare cocaine solution for use on a patient must be especially careful to ensure that they make no error in the identification of this drug. To assist with the accurate identification of the drug, pharmacy personnel may place a coloring agent into cocaine solution.
