This document discusses various supplies used for sterile compounding, including needles, syringes, IV bags, vials, and ampules. It describes the components and proper use of these supplies, emphasizing that critical sites must be touched only with sterile tools to avoid contamination. Most sterile compounding procedures use a regular needle that is 1 1/2 inches long and syringes to withdraw or inject solutions.

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Chapter 3
Sterile Compounding
Supplies
2012 Paradigm Publishing

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Learning Objectives
 Discover the origins of several sterile compounding supplies.
 Identify a variety of supplies used for preparing sterile
compounds.
 Describe various components of the most frequently used
sterile compounding supplies.
 Understand the rationale for using particular supplies in specific
compounding situations.
 Identify the critical sites of commonly used sterile compounding
supplies.
2012 Paradigm Publishing

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Topics
 Learning Objectives
 Introduction
 Correct Opening and Placement of Supplies
 Needles
 Specialty Needles
 Syringes
 IV Base Solutions
 IVPB Solutions
 Premixed Parenteral Products
 Vials
 Ampules
 IPA Swabs, Vented Dispensing Pins, IVA Seals, Sharps Containers
 Sterile IV Tubing
 Repeater Pumps
 Miscellaneous Sterile Compounding Supplies
 Chapter Summary
2012 Paradigm Publishing
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Introduction
 The critical site is the part of the supply item that
includes any fluid-pathway surface or fluid-pathway
opening that is at risk for contamination by touch or
airflow interruption
critical sites must only be touched by a sterile tool to avoid
touch contamination
 Anything that interrupts the airflow from the HEPA
filter to the critical zone causes shadowing, another
form of potential contamination
2012 Paradigm Publishing

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Correct Opening and Placement of
Supplies
 Take great care when opening the outer packages of
all supply items
the outer packaging is sometimes called a dust cover
keep the sterile supply item within the clean air zone
 Along the entire outer edge of the hood’s work
surface, measuring six inches into the hood, sterile
air from the hood’s HEPA filter mixes with turbulent
room air
this area is referred to as the outer six-inch zone, or the
zone of turbulence
2012 Paradigm Publishing

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Correct Opening and Placement of
Supplies…/2
 All sterile compounding
procedures must take
place at least six inches
inside of the hood,
thereby avoiding the
outer six-inch zone
2012 Paradigm Publishing

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Needles
 The needle is attached to a syringe and is then used
to either draw fluid into the syringe, (also known as a
straight draw) or push fluid out of the syringe and
into an IV bag or bottle
 Regular needles, the most commonly used, are used
specifically to withdraw or inject fluids for parenteral
administration
 Several components are common to every needle
2012 Paradigm Publishing

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Needles…/2
 The needle tip is at the
very end of the needle
and is razor sharp
 The tip of the needle
has a slanted opening
called the bevel
 The heel is the rounded
part of the bevel at the
point where the
slanted opening ends
2012 Paradigm Publishing

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Needles…/3
 The needle shaft provides length to the needle and
extends from the point where the colored needle hub
attaches to the metal needle, to the needle tip
 The inner core of the needle shaft is called the lumen,
a hollow space through which fluid moves into or out
of the syringe
 The needle hub is the end point, which attaches to
the syringe
 A hard plastic cap covers the needle shaft and tip until
the moment of use
2012 Paradigm Publishing

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Needles…/4
 Needle gauge refers to the diameter of the opening,
or lumen, of a needle
when drawing up a viscous liquid the IV technician would
choose a needle with a large gauge size but would select a
needle with a small lumen when providing an IM
medication for a neonate
2012 Paradigm Publishing

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Needles…/5
 IV technicians choose
needle lengths
according to the task
being performed
for most sterile
compounding
procedures, they
select a regular
needle with a
standard 1 ½" length
2012 Paradigm Publishing

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Needles…/6
 The standard recapping method requires the
technician to hold the filled syringe as she or he would
a dart and then recap the needle by holding the cap
between the thumb and forefinger of the nondominant
hand and carefully slipping it over the tip of the needle
 The scoop recapping method involves placing the tip of
the needle into the cap that is lying on an IPA swab on
the hood’s work surface
the IV technician uses the needle-and-syringe unit to scoop
the needle cap onto the needle
2012 Paradigm Publishing

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Specialty Needles
 The filter needle is a needle with a small, built-in
filter (sometimes referred to as a depth filter)
between the needle’s shaft and hub
used to remove particulate matter from a solution
 Technicians use the vented needle primarily to dilute
large-volume or multiple containers of parenteral
medications in powder form
these medications must be reconstituted prior to use
 The transfer needle transfers fluid from one vial or
container to another
2012 Paradigm Publishing

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Syringes
 Sterile compounding technicians use syringes to
withdraw or inject solutions as part of the
preparation of almost all sterile products
2012 Paradigm Publishing

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Syringes…/2
 The syringe tip may be either Luer-lock or slip-tip
to make a secure connection, you screw the needle onto a
Luer-lock syringe
a slip-tip syringe slides onto the hub of the needle
2012 Paradigm Publishing

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Syringes…/3
 The barrel of the syringe contains the calibration
marks for measuring fluid volume
 Inside the barrel of the syringe is a black, rubber-
tipped piston plunger
2012 Paradigm Publishing

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Syringes…/4
 Behind the piston plunger is the inner shaft of the
plunger
 The flat end of the plunger, most distant from the
needle end, is referred to as the flat knob, lip, or
heel of the syringe
 You can touch or hold the syringe only on the outer
barrel or the flat knob
the critical sites of a syringe are the tip or hub, the piston
plunger, and the inner plunger shaft
2012 Paradigm Publishing

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IV Base Solutions
 A large volume of sterile fluid
that is delivered via sterile IV
tubing
also known as a large-volume
parenteral (LVP), base solution,
primary IV, IV, or IV bag
contains a small plastic hang
loop
the IV technician injects
additives through the injection
port
2012 Paradigm Publishing

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IV Base Solutions…/2
 The nurse removes the rubber cap covering the bag’s
tubing port and inserts the tubing’s universal spike
adaptor into the tubing port
 The LVP is commonly the primary source of hydration
for the patient and is run continuously while the
patient is unable to take oral liquids
most LVP solutions are made with varying concentrations of
sodium and/or dextrose mixed with sterile water
 During the sterile compounding process, personnel
prepare IV solutions that require medication additives
2012 Paradigm Publishing

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Your Turn
2012 Paradigm Publishing
1) Most sterile compounding procedures use a regular needle with this
length.
a. 1″
b. 1 ¼″
c. 1 ½″
d. 1 ¾″
2) Sterile compounding technicians use these to withdraw or inject
solutions.
a. adaptors
b. syringes
c. ports
d. plungers
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IVPB Solutions
 An IVPB solution is a small
volume of fluid mixed with
an IV medication and
administered via sterile IV
tubing
IVPBs are a type of small-
volume parenteral (SVP)
product and are usually
“piggybacked” through a
primary IV line that contains
the IV base solution
2012 Paradigm Publishing

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IVPB Solutions…/2
 IVPB bag components are similar to those of an IV
base solution bag
 The IVPB medication is administered to the patient
intermittently, based on the frequency ordered by
the prescriber
 Many intravenously administered antibiotics are
delivered via an IVPB
2012 Paradigm Publishing

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Premixed Parenteral Products
 Some medications for
administration by IV or IVPB
are supplied in the form of
premixed, shelf-stable
products
IV bags that contain a standard
dose of potassium chloride
IVPB that contains a standard
dose of famotidine
prefilled syringe provided for
IV push use
2012 Paradigm Publishing

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Premixed Parenteral Products…/2
 Various IVPBs are supplied
in packages of 12, 24, or
48 and are shipped from
the wholesale supplier in
a container packed in
dry ice
 Other products commonly
used are systems such as
ADD-Vantage, MINI-BAG
Plus, and Add-A-Vial
2012 Paradigm Publishing

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Premixed Parenteral Products…/3
 These products require sterile compounding
personnel to screw or snap a specially built vial onto
an IVPB designed for this type of attachment
performed in the hood
 One advantage of this type of IVPB is that it can be
mixed just moments before the dose is required
helpful if the medication is not stable for long periods in its
mixed form
reuse is possible because these systems are stable for up
to 30 days
2012 Paradigm Publishing

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Vials
 Vials are sealed, sterile containers with a rubber top
most often contain a sterile medication, in a liquid or
powder form, or a liquid diluent
most commonly used diluents are sterile water and normal
saline
2012 Paradigm Publishing

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Vials…/2
 The two main types are single-dose vials (SDVs) that
do not contain a preservative, and multiple-dose
vials (MDVs) that do contain a preservative
 Mix-O-Vial is used infrequently by IV technicians due
to the limited number of immediate-use medications
supplied in this type of container
dislocating the plug releases the liquid into the powder,
which dissolves and is then drawn up in solution by the IV
technician for either an IV push or IVPB administration to a
patient
2012 Paradigm Publishing

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Ampules
 An ampule is a sterile, sealed container made
entirely of glass with a tapered neck
IV technicians break the glass at this tapered, scored neck
and aseptically remove the liquid with a needle and
syringe
the ampule is an appropriate container for drugs that are
not compatible with the rubber top or other components
of a vial
2012 Paradigm Publishing

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IPA Swabs, Vented Dispensing Pins,
IVA Seals, Sharps Containers
 Sterile IPA swabs are wiped across most critical sites
 Vented dispensing pins are inserted into a vial or
glass bottle and then attached to a syringe
2012 Paradigm Publishing

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IPA Swabs, Vented Dispensing Pins,
IVA Seals, Sharps Containers…/2
 IVA seals are small
foil stickers that
sterile compounding
personnel place over
the injection port of
the prepared IV,
IVPB, and various
other compounded
products
2012 Paradigm Publishing

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IPA Swabs, Vented Dispensing Pins,
IVA Seals, Sharps Containers…/3
 The sharps container is a
large bucket, usually red in
color, made of thick plastic
and used to safely dispose
of used needles, syringes,
and broken glass
chemotherapy waste must
be disposed of in a special
sharps container that is
typically yellow in color
2012 Paradigm Publishing

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Sterile IV Tubing
 Sterile IV tubing is a supply item frequently used
throughout the hospital
 Primary IV tubing is sterile IV tubing with multiple
injection ports
nurses use primary IV tubing to administer an IV base
solution to the patient
 Secondary IV tubing is short, sterile IV tubing that
may or may not have an injection port
IV technicians use secondary IV tubing to transfer a
solution from a source container to another bag or bottle
2012 Paradigm Publishing

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Sterile IV Tubing…/2
 Insert the universal
spike adaptor into the
tubing port
observe the drip
chamber to calculate the
flow rate
the roll clamp is used to
regulate the flow rate
the far end of the tubing
is called the needle
adaptor
2012 Paradigm Publishing

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Repeater Pumps
 Some sterile compounding facilities use repeater
pumps to rapidly transfer sterile fluids from large-
volume or bulk containers into small-volume
containers such as syringes or vials
when personnel must prepare large batches of fluid-filled
syringes of the same volume, a repeater pump is an
excellent alternative to drawing up the syringes from a
bulk container by hand
2012 Paradigm Publishing

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Miscellaneous Sterile Compounding
Supplies
 Other supplies that are
less frequently used but
still important to the
work of an IV technician
include syringe caps,
Luer-to-Luer
connectors, membrane
filters, and empty
evacuated containers
2012 Paradigm Publishing

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Miscellaneous Sterile Compounding
Supplies…/2
 A syringe cap is a small, plastic cap that attaches to
the tip of a filled syringe
 A Luer-to-Luer connector is a plastic tube with Luer-
lock hubs at both ends
 Membrane filters (0.2 micron or smaller) are used to
sterilize solutions that have been prepared using
nonsterile ingredients
 An empty evacuated container (EEC) is a sterile,
empty vial or glass bottle whose volume ranges from
2 mL to 1000 mL
2012 Paradigm Publishing

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Your Turn
2012 Paradigm Publishing
3) The sharps container is usually this color.
a. red
b. yellow
c. blue
d. black
4) Some sterile compounding facilities use these to rapidly transfer sterile
fluids.
a. drip chambers
b. syringe caps
c. membrane filters
d. repeater pumps
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