1. Gather equipment. Check medication order against original physician’s order according to agency policy.
  2. Perform hand hygiene.
  3. Remove the metal or plastic cap on the vial that protects the rubber stopper.
  4. Swab rubber top with alcohol swab.
  5. Remove the cap from the needle by pulling it straight off. (Some agencies recommend use of a filter needle when withdrawing premixed medications from multidose vials.) Draw back an amount of air into syringe equal to specific dose of medication to be withdrawn.
  6. Pierce the rubber stopper in the center with the needle tip and inject measured air into the space above the solution. (Do not inject air into the solution.) Vial may be positioned upright on a flat surface or invented.
  7. Inver vial and withdraw needle tip slightly so that it is below the fluid level.
  8. Draw up prescribed amount of medication while holding syringe at eye level and vertically. Be careful to touch the plunger at knob only.
  9. If any air bubbles accumulate in syringe, tap syringe barrel sharply and move needle past fluid into the air space to reinject the air bubble into vial. Return needle tip to the solution and continue withdrawal of medication.
  10. After correct dose is withdrawn, remove needle from vial and carefully replace cap over needle. If a filter needle has been used to draw up the medication and the medication needs to be administered through a needle. (Some agencies recommend changing needles, if needed to administer the medication, before the administering the medication.)
  11. If using a multidose vial, label the vial with the date and time opened and store the vial containing remaining medication according to agency policy.
  12. Perform hand hygiene.


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