Possibility and Risk of Medication Vial Coring in Interventional Spine Procedures

Kordi, Ramin; White, Bebo; Kennedy, David J.

doi:10.1016/j.pmrj.2016.09.003

Cited by 4 publications

(2 citation statements)

References 23 publications

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“…Coring is easily missed due to difficulty in visualization because of its small size, the masking effect of the vial labels, or the medication opacity [2]. In reported cases, the consequences range from undetectable localized tissue trauma to severe morbidity and death [3]. Coring may only be detected with careful inspection of all medication syringes, after infusion pump tubing gets blocked, or when a patient exhibits signs of an adverse event [4].…”

Section: Discussionmentioning

confidence: 99%

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Coring Revisited: A Case Report and Literature Review

Hruska¹,

Saasouh²,

Alhamda³

2022

Cureus

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Coring is the retention of material from a medication vial into the needle and syringe, which can ultimately be transfused into a patient, causing adverse outcomes. The purpose of this article is to increase awareness of this underreported finding and to propose solutions to improve the quality of care and decrease fatalities.A 65-year-old male with a significant cardiovascular history was admitted and required an emergent bedside esophagogastroduodenoscopy, for which propofol was being aspirated for IV induction. This resulted in the coring of the vial topper and subsequently a rubber piece in the syringe.The prevention of coring has largely focused on anticipating the shortcomings of currently available medication vials and aspiration techniques. However, these strategies have limitations. Further work can highlight risk-mitigating approaches such as different aspiration techniques, needle or vial types, and prefilled syringes. More importantly, these interventions may reduce perioperative morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

“…Coring may only be detected with careful inspection of all medication syringes, after infusion pump tubing gets blocked, or when a patient exhibits signs of an adverse event [4]. This is a recognized and largely preventable source of patient harm and has mostly been addressed anecdotally in the published literature [2,3,5].…”

Section: Discussionmentioning

confidence: 99%