Syringe drug labels: a French national survey

Introduction

The French Society of Anaesthesiology (SFAR) recommends the use of pre printed self-stick syringe labels. However, French anaesthesia-syringe labelling customs is yet unknown.

Study design

Therefore, a national phone survey was performed in order to investigate this issue.

Results

Forty-five percent of the answering centers (324/722) used colour self-stick labels, with a larger proportion in public centers and a large regional variability. The kind of colour code differed from an area to another. Among centers using colour labels, the international recommended colour code was used in only 36% of them. The majority of health care providers declare to be favourable to the use of the colour self-stick labels and the standardization of the colour code as well. A relationship between the University hospital and the surrounded area has been observed for the use of the colour labels and the choice of the colour code.

Conclusion

Colour labels are used in France by nearly half of the centers, but international colour code is less spread.     

Syringe labels in anaesthetic induction rooms

A survey of 35 hospitals in the United Kingdom has uncovered a wide variety of syringe drug labels. Use of different systems in different hospitals may result in wrong drug administrations, particularly when trainees move from one hospital to another. There is an urgent need to standardise the colour coding of syringe labels in the United Kingdom. Such standards are already in place in Australia, New Zealand and in the United States of America. This survey of syringe drug labels highlights the existing risks and recommendations for change are made.     

Comparison of semitransparent colored labels with opaque colored labels for prevention of adverse drug administration

BACKGROUND: We made a semitransparent color label to supplement a demerit of an opaque color label for prevention of adverse drug administration, and evaluated whether a semitransparent color label is superior to an opaque color label. METHODS: We prepared a total of 16 syringes (8 colors; two syriges of each color) in the opaque (NC) group and in the semitransparent (CL) group. Each ten subjects were asked to pick up the same drug label alternately in each group, and we measured the time and the number of syringes until the examinee can pick up the five correct syringes. We also examined the adhesiveness of the label to the syringe for six hours in each group. RESULTS: The time and syringe number until the examinee could pick up five correct syringes were 24.6+/-4.6 seconds and 16.2+/-2.7 in NC group (P= 0.0004) and 10.9+/-3.7 seconds and 6.5+/-1.7 in CL group, respectively (n-10, each, P <0.0001). In CL group the label adhered to the syringes tightly for six hours, whereas all the labels in NC group were detached (P<0.0001). CONCLUSIONS: The semitransparent color label is superior to the opaque color label in discrimination and adhesion.     

Syringe size and flow rate affect drug delivery from syringe pumps

PURPOSE: To evaluate the effect of syringe size and infusion rate on drug delivery after vertical displacement of syringe pumps. METHODS: Four syringes (10 ml, 20 ml, 30 ml, 50 ml) were studied at three infusion speeds (2 ml x hr(-1), 1 ml x hr(-1) and 0.5 ml x hr(-1)). Fluid delivery was measured gravimetrically using an electronic balance. Aspiration volume (amount of fluid retracted into the syringe-infusion line assembly) and zero-drug delivery time (time between the lowering of the syringe pump and reattainment of the initial weight) were determined after lowering the syringe pump 130 cm or 50 cm. Then, infusion bolus was measured after elevating the pump to its initial position. Syringe compliance was calculated from the occlusion release bolus at an occlusion pressure of 300 mmHg. RESULTS: Zero-drug delivery time, aspiration volume and infusion bolus increased with syringe size (P < 0.0001). At 0.5 ml x hr(-1), a zero-drug delivery time of 29.7 +/- 0.6 min was recorded for the 50 ml syringe and 5.5 +/- 0.15 min for the 10 ml syringe. As infusion rates increased, zero-drug delivery times decreased following a 1/x ratio. Zero-drug delivery time highly correlated with calculated syringe compliance (Pearson's r = 0.97, P < 0.001), which was closely related to syringe plunger area (R2 = 0.93, P < 0.001). CONCLUSIONS: Vertical displacement of syringe pumps causes flow irregularities which correlate directly with syringe size and indirectly with infusion rate. Extreme vertical maneuvering of syringe pumps should be avoided. Infusion rates > or = 1 ml x hr(-1) and low-compliant, small syringes are recommended when highly concentrated drugs are administered.     

Standardized colour coding for syringe drug labels: a national survey

A standardised colour code for user-applied syringe labels for anaesthetic drugs exists in the USA, Australia, New Zealand and Canada. In the UK, there is none. Consequently, an assortment of colour codes for syringe labels is available in the UK. We conducted a postal survey of the 285 College Tutors of the Royal College of Anaesthetists to establish their local syringe drug labelling system and their views on a national, standardised colour code. We found that that 96% of departments currently use coloured syringe drug labels. Of these, 98% use the 'Medilabel' scheme. The College Tutors felt that a standardised colour code for labels is required (94%), that the Association of Anaesthetists or the Royal College of Anaesthetists should be involved in the choice of scheme (76%) and that the scheme chosen should be international (65%). There was a majority feeling that the opinions expressed were representative of other members of the College Tutors' departments. We conclude that a national standard for drug labels is required and that a choice will have to be made between the 'international' scheme and the currently dominant Medilabel scheme.