Product Spotlight: Pre-Filled OR Syringes from PharMEDium Services, LLC

July 2008 - Vol.5 No. 7

By Dennis Roberts, DPh

The Regional Medical Center at Memphis is a critical access teaching hospital, affiliated with the University of Tennessee and operating eight centers of excellence, including burns, level 1 trauma, high-risk obstetrics, wound care, newborn, adult special care, sickle cell, and bariatric care. We are licensed for 355 beds and and 25% to 30% of our patient population is indigent or self pay.

To ensure the proper labeling and beyond-use dating for our OR syringes, per the Joint Commission’s requirements, pharmacy had long been drawing up several anesthesia tray products on a daily basis for use in our four operating suites. Unused products had to be destroyed after 24 hours if they had been prepared in our IV room. However, in November 2007, we became aware of PharMEDium’s intent to produce an OR syringe product line, which offered universal color-coded labeling, individual shrink-wrapping for security, and 45-day beyond-use dating. After considering the potential benefits of this product line, in March 2008, we began outsourcing the preparation of our cefazolin, phenylephrine, ephedrine, and succinylcholine to PharMEDium as a beta site for their
OR syringes.

Cost Considerations
The cost of a PharMEDium syringe is considerably higher than the cost of preparing a product in-house, even with the associated labor reduction. However, with just 24-hour dating on products compounded in-house and the syringe quantities anesthesia required to be on-hand, we were destroying 60-plus syringes daily. This made the premium PharMEDium charges for its syringes financially feasible for our organization, as we stood to waste fewer syringes with their extended beyond-use dating. Furthermore, in using PharMEDium’s cefazolin syringes as a push, we eliminated the cost of piggyback tubing, which is actually more expensive than the drug itself.


Acceptance From Anesthesia
Anesthesia has quickly accepted the new cefazolin push syringes, since they can be administered in two to three minutes, versus the 30 minutes needed for cefazolin piggybacks. The shorter administration time also made it easier to comply with the Centers for Medicare and Medicaid Services (CMS) core measures
for surgical infection prophylaxis, which require the medication to be administered within the hour prior to surgery. Our anesthesiologists also like the standardized labeling and color-coding of PharMEDium’s syringes, in addition to the shrink-wrapping and individually sealed plastic bags, which ensure sterility in the operating room.

We have realized a number of benefits from outsourcing our OR syringes
to PharMEDium. For instance, we have been able to redeploy pharmacy compounding labor to other activities and the new syringes increase our ease of stocking anesthesia trays, because we can now prepare them well in advance of their expected use. We have also noted a significant reduction in costs and waste associated with cefazolin since switching from piggybacks to PharMEDium’s push syringes, due to the elimination of the tubing. In addition, inventory control has been simplified. Our buyer places a weekly order, and we currently stock five boxes of 25 cefazolin syringes and two boxes of 25 each of the other products. Because of the success of this program, we have asked PharMEDium to consider compounding additional syringes, such as ceftriaxone with lidocaine for IM injections given in the emergency department 


Dennis E. Roberts, DPh, is the assistant director of pharmacy operations at the Regional Medical Center in Memphis. He is a graduate of the University of Tennessee School of Pharmacy.


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