Oral Dispensers(Oral Syringes): syringe-like devices with a unique tip configuration that cannot accommodate a hypodermic needle or actuate a needleless IV access port. Baxa Exacta-Med Dispensers were the first devices specifically designed to provide safe and accurate delivery of oral liquids. The new dispensers' purple plunger provides additional differentiation, makes training easier and further reduces the possibility of wrong-route administration through a patient's IV or epidural lines.

Vial: a glass or plastic container/ bottle sealed with a stopper

Multi-dose vial: a vial sealed with a stopper intended to be accessed with a needle and syringe on more than one occasion. These vials usually contain a single adult dose.

The use of multi dose vials can be indicated for the reasons of availability, storage issues or cost issues.

Multi use of medication vials is limited to products that are known to remain stable and retain potency for at least 24 hours, under refrigeration (ie 2-8 degrees C). Such products should be packaged in original containers (multi-dose vials) with stoppers or seals that remain intact following needle piercing. Approval for multi-dosing in other circumstances (eg packaging under sterile conditions, products needing to be frozen) should be sought from the RCH pharmacy department.

Vial preparation

* Wash or disinfect hands

* Swab vial top with a sterile alcohol swab (70% isopropyl alcohol)

* Allow top to dry for 30 seconds

* Using a non-touch technique, reconstitute vial with sterile water for injection unless another diluent is specified. Discard unused diluent.

* Dissolve medication completely or if a suspension, mix well

* The syringe and needle used for reconstituting may be used for the first dose only. A new sterile syringe and needle is to be used for each subsequent time the vial is accessed.

Storage of multi-dose vials

* Multi dose vials of reconstituted medications are to be stored under refrigeration at 2 to 8 degrees and used within 24 hours of preparation or first use/ piercing (assuming medication stability at this temperature and for this period)

* Reconstitution of the medication and subsequent withdrawing of doses must be performed under strict aseptic technique. (See section 2: vial preparation)

* Vials must be clearly labelled with date and time of first use