To the Editor

Regarding the article on the sterility of IV medications drawn up into syringes (APSF Newsletter, Summer 1999), I must comment. From a patient safety standpoint, sterility is a secondary issue. The potential cost savings of using previously drawn-up drugs must be weighed against the possibility of “wrong-drug” administration, whether from an accident of medication handling or malicious tampering with labeled syringes. For example, the contents of a “clean” unused syringe labeled as pancuronium looks exactly the same as fentanyl and, also, potassium cloride.

Unless drawn-up syringes intended for use later in the same day are very carefully stored and personally kept with the original anesthesia provider who filled them, they must be discarded. One patient death will quickly consume many times over any money saved by years (? decades) of trying to economize by holding over filled syringes in a casual manner.

Allan J. Schwartz, CRNA, DDS
Columbia, MO