1. Chapter 4 Medication Administration
Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc.

2. Know The Law!!!!
Know: Job Description Institutional Policies State Law Professional Practice Standards

3. Objective 1
Describe the role of the Surgical Technologist in medication administration.
Circulator
First scrub (STSR)

4. Objective 1. Circulator Obtain medications. Identify medications.
Deliver medications.

5. Objective 1. Circulator
Maintain asepsis during delivery to sterile field.
Document medications.

6. Objective 1. STSR
Accept medications.
Identify medications.

7. Objective 1. STSR
Label medications immediately.

8. Objective 1. STSR Pass medications.
Say the name of drug clearly when passing it to surgeon.

9. Explain the 6 “Rights” of medication administration.
Objective 2
Explain the 6 “Rights” of medication administration.

10. Objective 2. Right drug
Read preference card and medication label carefully.
(From Morris DG: Calculate with Confidence, 3rd ed, St. Louis, Mosby, 2002)

11. Objective 2. Right drug Say drug name when handing to surgeon.
Keep vials in room.

12. Objective 2. Right drug CAUTION:
Some drugs sound alike or are spelled alike.
For example:
Pitocin/pitressin
Epinephrine/ephedrine

13. Objective 2. Right dose Correct amount (volume)
30 ml
Correct strength (concentration)
1%, 2%, 0.5%
The right dose is the amount multiplied by the strength.

14. Objective 2. Right dose Vital when mixing medications on back table
Vital when multiple strengths of the same medication are on back table
Label each medication carefully.

15. Objective 2. Right route
Surgeon administers medications at the surgical site.
Surgeon determines route.
STSR role in right route
Correct formulation of drug

16. Objective 2. Right route For example, epinephrine
Strength for topical is 1:1000
Strength for injectable is 1:100,000
Both are clear solutions.

17. Route/CAUTION!
You must know the route and purpose for different epinephrine strengths.
A mix-up can cause patient death.

18. Objective 2. Right patient
Identify patient.
Verify surgeon and procedure.
Check preference card.

19. Objective 2. Right time Per verbal order
Surgeon administers medications at the surgical site at the intended time.

20. Describe the steps of medication identification.
Objective 3
Describe the steps of medication identification.

21. Objective 3.Med ID steps Read label when obtaining drug.
Check integrity of container.
Circulator reads label to STSR.

22. Objective 3.Med ID steps
Circulator shows label to STSR.

23. Objective 3.Med ID steps STSR repeats information.
Medication is delivered to field.
Medication is labeled.

24. Objective 3. Med ID steps Warning:
Do NOT accept any medication onto your back table without reading the label first.

25. Objective 4
Discuss aseptic techniques for delivery of medications to the sterile field.

26. Objective 4. Asepsis/delivery
Vials:
Do NOT touch rubber stopper.
Do NOT touch syringe plunger.

27. Objective 4. Asepsis/delivery
Vials: pouring
Remove stopper without
touching lip of vial.

28. Objective 4. Asepsis/delivery
Vials: pouring
Pour away from area where stopper removed.

29. Objective 4. Asepsis/delivery
Vials: pouring, vial decanter

30. Objective 4. Asepsis/delivery
Vials: pouring
Or hold vial inverted (away from table) for STSR to draw up.

31. Objective 4. Asepsis/delivery
Ampules
Protect hands when breaking ampule.

32. Objective 4. Asepsis/delivery
Pour bottles
Cap up and off
Empty all contents at once.
Do NOT recap.

33. Objective 4. Asepsis/delivery
Circulator should NOT lean over sterile back table to deliver medications.
STSR should hold medication container out away from back table for circulator.

34. State the procedure for labeling drugs on the sterile back table.
Objective 5
State the procedure for labeling drugs on the sterile back table.

35. Objective 5. Labeling
All medications must be labeled immediately after accepting from the circulator!

36. Objective 5. Labeling Label intermediate container
Med cup, pitcher, basin
Label administration item
Syringe

37. Labeling options Preprinted labels
Write drug name, expiration date, and strength with skin marking pen on
Blank label
Skin adhesive strips

38. Objective 5. Labeling NOTE:
Failing to label all medications on the sterile back table is unacceptable practice and probable negligence.

39. Identify supplies used in medication administration in surgery.
Objective 6
Identify supplies used in medication administration in surgery.

40. Objective 6. Supplies Intermediate containers Pitchers, basins
Med cups
Petri dishes

41. Objective 6. Supplies Administration items Syringes Parts of a syringe
Sizes and tips
Types of syringes

42. Objective 6. Supplies Administration items Hypodermic needles
Parts of a needle
Gauge and length

43. In summary
The surgical technologist’s role in medication administration in surgery is VITAL!

44. In summary The ST All must be correct. Identifies medications
Labels medications
Passes medications
All must be correct.