Manage Epinephrine Syringe Shortages

A common occurrence in hospitals is when Epinephrine (Epi) pre-filled syringes go on shortage and are hard to purchase. When this happens, you might need to create an Epinephrine kit (Epi Kit) to account for the Epinephrine pre-filled syringes shortage. 

There have been other workarounds to manage Epinephrine pre-filled syringe shortages, but these workflows come at the cost of capturing valuable data for all components, such as NDC, lot numbers, and expiration data.

This file details how account for Epinephrine pre-filled syringe shortages while still capturing all data for the necessary components. This includes:

• Find kits containing Epinephrine pre-filled syringes
• Add Alternate Fill option for Epinephrine pre-filled syringes
• Add the Epinephrine diluent segment

Find Kits Containing Epinephrine Pre-filled Syringes

When Epinephrine pre-filled syringes go on shortage, the first step is to locate those kits so you can adjust the segment and alternate fills to accommodate the shortages. Search for the Epinephrine pre-filled syringe item in the Formulary. Then, you can use the Kits & Bins Containing Specific NDC/Lot Number report to find the kits that had those Epinephrine pre-filled syringes in their last scan. 

To access the report:

1. From the Reports drop-down, select Show Hospital Reports.
2. Select Kits & Bins Containing Specific NDC/Lot Number. 

Add Alternate Fill Option 

Once you have identified the kits that contained Epinephrine pre-filled syringes, you will need to add an alternate fill for Epinephrine that can be mixed bedside with a diluent. To add an Alternate Fill Option for Epinephrine pre-filled syringes:

1. From the Inventory drop-down, select Manage Kit Masters.
2. Select the kit master that contains Epinephrine pre-filled syringes and needs to be managed for a shortage.
3. Click the Epinephrine (pre-filled syringe) segment. 
4. In the Edit Segment screen, click Add Fill Option section.
5. Search and select the Alternate Fill Option. This should be an Epinephrine component that will be mixed with a diluent in your Epi Kit. 
   Tip!

   This Epinephrine component is usually an Epinephrine 1 mg/mL vial or ampule.
6. Select if you want to add only the chosen formulary item or if you want to include generic items. 
7. Click Save. 
8. Click Done. 

Add Epinephrine Diluent Segment

After you add the Alternate Fill for the Epinephrine pre-filled syringe, you will need to add another segment for the diluent to mix with the alternate fill medication.

1. In the same kit master that required an alternate fill for an Epinephrine pre-filled syringe, click New Segment. 
2. Enter the Segment Name.
3. Enter the required Quantity. This should be the same par as the quantity set for the alternate fill for the Epinephrine pre-filled syringe. 
4. Search and select the diluent. This is usually a vial of Sodium Chloride 0.9% vial or flush syringe. 
5. Select if you want to add only the chosen formulary item or if you want to include generic items.
6. Click Save.
7. Adjust the Shortage Range to your required amount for bedside usage. This should be the same shortage range for the quantity set for the alternate fill for the Epinephrine pre-filled syringe.
8. Click Done. 

Because the Epinephrine option you have added as the alternate fill AND the diluent you have added are formulary items, each of these medications has its own NDC, lot number, and expiration date. This allows you to keep track of all medications used for bedside mixing.