Skill 51
Parenteral Medications
Mixing Medications in One Syringe
Some medications need to be mixed from two vials or from a vial and an ampule. Mixing compatible medications avoids the need to give a patient more than one injection. Compatibility charts are in drug reference guides, posted within patient care areas, or available electronically. If you are uncertain about medication compatibilities, consult a pharmacist. When mixing medications, you must correctly aspirate fluid from each type of container. When using multi-dose vials, do not contaminate the contents of the vial with medication from another vial or ampule.
Give special consideration to the proper preparation of insulin, which comes in vials. Insulin is the hormone used to treat diabetes mellitus. Insulin is classified by rate of action, including short duration, intermediate duration, and long duration. Often patients with diabetes mellitus receive a combination of different types of insulin to control their blood glucose levels. Before preparing insulin, gently roll all cloudy insulin preparations (Humulin N) between the palms of your hands to resuspend the insulin (Lehne, 2010).
If more than one type of insulin is required to manage the patient’s diabetes, you can mix them into one syringe if they are compatible. Always prepare the short- or rapid-acting insulin first to prevent it from being contaminated with the longer-acting insulin (Lehne, 2010). In some settings insulin is not mixed. Box 51-1 lists recommendations for mixing insulins.
Box 51-1
Recommendations for Mixing Insulins
