Instructions:

1. Package opens upside down
2. Stick finger in on side (like opening a pasta box) and remove bottom
3. Remove medication and syringe
   • Sometimes easiest to dump out the box on a hard surface
4. Remove caps from vial and injector
   • The parts to remove are often all one color such as yellow
5. Hold one in each hand and flick off the caps with your thumbs
6. Insert Vial into injector
   • Do not use excessive force causing medication to leak out
7. Screw the two pieces together (about three full turns)
8. Remove cap on Luer lock adapter
9. Remove just cap and not luer lock adapter
   • Cap is often yellow (color of things to remove) and the luer lock adapter is green
   • If you remove the luer lock adapter you are left with just a needle (needles alone rarely used in inpatient)
10. Keep Luer lock piece on syringe to connect to IV/IO/CL/Port
11. Give medication as/when verbally ordered by Code leader
    • A code leader asking for a medication to be prepared does not mean to give it, you must wait until they also say to deliver the medication
12. Connect to IV/IO/CL/Port
13. Deliver medication by pressing medication vial into the syringe

<aside> 💡

Important Points

• Usually found in the medication box or drawer
• Types of medications found in Bristojet form:
  • Epinephrine, Atropine, Adenosine, Lidocaine, D50, Bicarb
  • It is preferred that mediation is given at the beginning of the 2-minute CPR cycle
• Medication is already premixed and ready to deliver
  • The dose of a Bristojet is usually already in AHA recommended single doses
  • Sometimes, a half a dose is appropriate, follow doctor's orders
  • Ex: adenosine bristojet usually comes in 12 mg dose syringes. The protocol is sometimes to deliver 6mg in the first dose, followed by 12mg for each additional dose
• Safety warning: once the caps are off, a needle is exposed and can lead to needle sticks. The vials are glass and can break easily. </aside>