Collective efforts drive medication error prevention, spanning training, protocols, and compliance. Despite strategies like the Five Rights of Medication Administration and National Patient Safety Goals, errors persist due to medication variety and healthcare system complexity. There is no patient care delivery area that highlights these challenges more than anesthesia. In fact, the American Association of Nurse Anesthetists described it as “one of the few areas in healthcare in which medications are prescribed, mixed, relabeled and administered without safety checks and secondary verification”. Providers use various methods to identify the type of anesthesia, including ASTM color guidelines, to help minimize errors in this environment. Here’s how they can enhance safety in your operation.

What Are ASTM Color Guidelines?

ASTM International is a global leader in developing standards for over 150 different industries including healthcare and pharmaceuticals. ASTM standards are developed through the expertise and judgment of members in each respective industry. In healthcare, the guidelines apply to each unique drug classification, which is assigned a specific color by the ASTM. For example,

• Blue labels - opioids
• Fluorescent red - neuromuscular blockers
• Yellow - induction agents
• Orange - tranquilizers
• Violet - vasopressors
• Green - anticholinergics

Why Are ASTM Color Guidelines Important?

ASTM color guidelines aid in the safe dispensing of user-prepared medication syringes. For example, when a patient requires an opioid, the clinical staff knows the syringe should contain a blue colored label. This visual queue offers an additional means to distinguish between various types of anesthesia which is especially important in the operating room, where distractions can present obstacles to the clinical staff. To manage these distractions, some tasks that are repeatedly performed may rely on working memory. Color coding offers redundancy cues that support working memory. Without the color queues, providers may unintentionally use less reliable options such as size or location.

Challenges With Using ASTM Color Guidelines

Our brains are better at storing and retrieving information when we use multiple senses. But not when the information we’re retrieving is inconsistently presented. Although using the ASTM color guidelines have the potential to improve the accuracy of medication administration, the lack of a standardized and universally implemented system enforced by accrediting organizations is a problem. The inconsistencies can lead to misidentification of medication syringes, medication errors, and adverse patient outcomes.

In addition, with multiple high-risk medications within the same drug class an over-reliance on one variable, like color when selecting a syringe, poses significant error risks.

How to Use ASTM Color Guidelines Effectively

While ASTM color guidelines are valuable, they are not intended to be the sole method for identifying and distinguishing medications. But, they are effective when incorporated into the medication labeling process. For example, an anesthesia label that includes the drug name, concentration, time and expiration date, combined with the ASTM color classification, incorporates the essential checks that should occur with each patient and the color queue. Collectively, they work in concert to elevate medication safety.

In addition, another area that remains an ongoing challenge is confusion over similarly named drugs. The ISMP recently updated their confused drug names list which now includes over 150 different items. Because similar-sounding drugs often fall into different drug classifications Tall Man and Look-Alike Sound-Alike flags, which incorporate the ASTM color guidelines, serve to alert the medical staff and help prevent mistakes.

Ultimately, to facilitate medication syringe identification, color-coded labels require a standardized guideline with strict practice enforcement. Enforcing this standard across anesthesia service areas, like preoperative, post-anesthesia care, labor and delivery, and emergency departments, will enhance safety. Further, simplifying processes will likely lead to improved safety outcomes.

United Ad Label

United Ad Label has extensive experience implementing effective anesthesia labeling processes in healthcare settings. Contact us to learn more.