Hi, all -

How does your organization handle IM injections with volumes that exceed maximum recommended doses? We've seen a few examples recently, such as methotrexate for ectopic pregnancy and ceftriaxone.

Our pharmacists have been separating into multiple syringes and hand-writing "1 of 2" and "2 of 2" on the individual syringes, however, a single barcode scan at med admission would technically "fulfill" the entire order so there's risk of only partial med administration.

If you have any suggestions or lessons learned, I would appreciate your thoughts! Of note, we're an Epic shop.

Thanks!
Kelsey Keeley