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vent such theft by stealthy and motivated individuals driven by addiction.
Propofol is still non-controlled at most facilities, and the theft and illicit use of
the drug is a threat and concern. Ideally, the number of vials and the number of
milligrams used for each patient should be quantitated and rectified with sup-
plies at the end of the day, just as narcotics are tallied. This security step isn't
currently mandated, but don't be surprised if it is in the future.
Screen your drug drawers for look-alike and sound-alike drugs. Don't pur-
chase or store drugs with look-alike labels. If a look-alike drug ampoule arrives,
return it and seek a drug from a different vendor. If no alternate vendor exists,
place an orange warning label on similar looking ampoules to alert staff and
anesthesia providers to double-check the contents before use.
Operating room carts should contain only drugs for daily non-emergent use.
Store emergency ACLS drugs in immediate-use syringes separately from rou-
tinely used drugs. Finally, don't stock harmful medications such as epinephrine,
undiluted phenylephrine, potassium chloride, nitroprusside, or insulin in general
storage locations.
OSM
Dr. Novak (rjnov@yahoo.com) is the medical director of the Waverley Surgery
Center in Palo Alto, Calif., and an adjunct clinical associate professor of anesthesia
at Stanford University. Check out his blog at theanesthesiaconsultant.com.
