Question

Preparation #2:      Fentanyl 2-mcg/kg Syringe for IV Push

Case:   Patient MO is a 53 y/o AA male who was involved in a motor vehicle accident (MVA). The EMS transported him to a trauma unit. MO is currently on mechanical ventilation and in severe pain. MO is 6’1” tall and weighs 187-lbs. He initially received fentanyl IV push and now requires a maintenance dose. His prescribed regimen for pain maintenance is:

Calculations:

1. Calculate the dose (mcg) of Fentanyl for patient MO. (Round to the nearest microgram)

2. Calculate the volume (mL) of Fentanyl Citrate 250 mcg/5 ml IV Solution for this dose.

Supplies needed:
Fentanyl 250-mcg/5-mL Injection Solution, 5-mL Ampule	18 G 1.5 in filter needle
Ampule breaker or sterile syringe	21 G 1 in needle
	Sterile Syringes

Procedure:             

1. Perform all necessary calculations to prepare the CSP.
2. Gather all necessary equipment and supplies to prepare the CSP.
3. Prepare all equipment and supplies and introduce into LAFW
4. Using an ampule breaker, break the neck of the ampule.
5. Attach a filter needle to the syringe.
6. Withdraw desired volume of solution from ampule (bevel down in shoulder of ampule)
7. Remove solution from needle (into syringe).
8. Displace air bubbles towards tip of syringe, then evacuate air from the syringe
9. Recap needle, detach and discard in sharps container.
10. Attach a sterile syringe tip cap the syringe
11. Place finished CSP and empty drug containers in the tote and place in pass-through for verification.

CSP Risk Level:                                                

            

Why?

Answer 1

#. Calculations :-

Weight of the patient is 187lbs = 187×0.45= 84.15kg

Ordered dose of fentanyl is 2mcg/kg = 2×84.15= 168.3 mcg

Dose of mcg of fentanyl is 168.3 mcg

Available dose of fentanyl is 250mcg/5ml

Using unitary method :-

250mcg of fentanyl is available in 5ml

1mcg of fentanyl will be available in 5/250ml

Then 168.3 mcg will be available in 5/250× 168.3

= 3.3 ml

CSP risk level - Low-risk Level

Sterile commercial drugs using commercial sterile devices; ISO Class 5 environment at all times

Simple admixtures compounded using closed system transfer methods; administration must start no later than 12h after preparation