Paralytic drugs, also known as neuromuscular blocking agents, bear a heightened risk of causing significant patient harm when they are used in error. For this reason, they are classified as high-alert medications and require special safeguards to reduce the risk of errors and minimize harm.

To that end, HealthPRO strongly encourages suppliers to follow the recommendations outlined in the Institute for Safe Medication Practices Canada (ISMP) and Health Canada’s Good Package and Label Practices Guide for Prescription Drugs, especially as they pertain to:

• the ferrule;
• cap colour;
• and warning statement

Additionally, part of HealthPRO’s evaluation criteria is the availability of syringe labels.

We recommend that suppliers include a label that follows the standards defined by the Canadian Anesthesiologists’ Society (CAS) and the American Society of Anesthesiologists (ASA), which are supported by ISMP Canada. This includes a peel-off label on the vial, or additional auxiliary labels included in the box, that:

• Can be used for application to syringes once the medication is withdrawn from the vial
  
• Follow the colour scheme and include content information recommended by CAS and ASA

References:

• Institute for Safe Medication Practices Canada and Health Canada. Good Label and Package Practices Guide for Prescription Drugs, June 2019.
• Institute for Safe Medication Practices Canada and Health Canada. Neuromuscular Blocking Agents: Sustaining Packaging Improvements over Time, July 30, 2014.
  
• American Society of Anesthesiologists. Statement on labeling of Pharmaceuticals for Use in Anesthesiology. 
  
• CAN/CSA-Z26825:10 (R2020) Anaesthetic and respiratory equipment - User-applied labels for syringes containing drugs used during anaesthesia - Colours, design and performance