✦ = 3–6 points
✶ = 7–9 points
1. ✦ Check the medication against the
physician’s medication order, as
instructed in the “three befores.”
2. ✦ Do not open the ampule until you
are ready to withdraw the ﬂuid.
3. ✦ Perform hand hygiene and apply
4. ✶ Snap your thumb and middle
ﬁnger gently against the tip of the
ampule to move all the medication
away from the neck and into the
bottom of the ampule (Figure A).
5. ✦ Clean the neck of the ampule
using an alcohol swab.
6. ✶ Using one hand to hold the
bottom of the vial, snap o the top
with the other hand using a gauze
square to prevent a cut when the
glass neck breaks (Figure B).
7. ✦ If the top of the ampule does not
snap o easily, you may have to
use a ﬁle to create a cut or “score”
the ampule at the neck. The glass
ampule should then break easily
at this point (Figure C).
8. ✶ Insert a ﬁlter needle (attached
to a syringe) into the ampule
and withdraw the ﬂuid without
touching the sides of the ampule.
9. ✶ Withdraw all the medication from
the ampule. It may be necessary
to tip the ampule slightly to
withdraw all the ﬂuid.
10. ✦ Discard the broken ampule into a
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