​Statement on Standard Practice for Avoidance of Medication Errors in Neuraxial Anesthesia

Developed By: Committee on Quality Management and Departmental Administration
Last Amended: December 13, 2020 (original approval: October 20, 2010)

Syringe labels are not required for neuraxial anesthesia when the procedure is performed by one anesthesiologist or delegated anesthesia provider who is responsible for drawing up and administering all medications that are subsequently immediately administered. If the anesthesiologist or delegated anesthesia provider requests assistance with the procedure, he/she remains responsible for administering all medications. If administration of medications is deferred to another person, all syringes must be labeled in accordance with accepted standards. Regarding medications obtained from outside the sterile field (medications not pre-packaged in the spinal or epidural kit):

1. Medications drawn up in sterile fashion directly from a vial by the person doing the procedure (e.g., local anesthetic not provided in the kit or additional saline for epidural placement) must be labeled and have the drug name and concentration and expiration date checked by the person performing the procedure and the assistant.
2. Medication(s) drawn up into a syringe that are to be added from outside the sterile field during the procedure must be labeled in accordance with accepted standards. When these medications are added the person performing the procedure must confirm the drug, concentration, and dose with the assistant.