OR Playbook
Step 3 · Drugs

Drawing Up & Labeling Drugs

Which syringe size goes with which drug, the color-code system, and how to label so you never give the wrong thing.

8 min read

The TL;DR

  • Every syringe gets a label — drug, concentration, your initials, date/time. No exceptions, ever.
  • Syringe size is matched to the volume you'll give: propofol → 20 mL, fentanyl → 3–5 mL (50 mcg/mL), succinylcholine → 10 mL, glyco → 3 mL.
  • Labels follow the ISO 26825 color classes: yellow=induction, blue=opioid, red=relaxant, violet=pressor, orange=benzo, green=anticholinergic.
  • Read the vial label THREE times: picking it up, drawing it up, throwing it away.
  • An unlabeled syringe is a hazard — if you find one and don't know what's in it, discard it.

01Match the syringe to the dose

Syringe size isn't arbitrary — you pick the size that fits the volume and titration of the drug. Too big and you can't dose precisely; too small and you're constantly refilling.

This is a typical adult set, induction through reversal. Concentrations are standard stock — always confirm against your vial, and exact syringe sizes vary by institution.

DrugSyringeConcentrationClass
Propofol20 mL10 mg/mLInduction
Fentanyl3–5 mL50 mcg/mLOpioid
Midazolam3 mL1 mg/mLBenzodiazepine
Lidocaine5 mL10 mg/mL (1%)Local — blunts propofol burn
Succinylcholine10 mL20 mg/mLDepolarizing relaxant
Rocuronium5 mL10 mg/mLNon-depolarizing relaxant
Neostigmine (+ glyco)5 mL1 mg/mLReversal
Sugammadex2–5 mL100 mg/mLReversal (roc/vec)
Phenylephrine10 mL100 mcg/mLVasopressor
Ephedrine10 mL5 mg/mLVasopressor
Glycopyrrolate3 mL0.2 mg/mLAnticholinergic
Fentanyl is drawn undiluted at 50 mcg/mL (from a 100 mcg/2 mL or 250 mcg/5 mL vial) into a small 3–5 mL syringe — not a big, diluted one. Reversal (neostigmine + glycopyrrolate, or sugammadex) is usually drawn up toward the end of the case.
Standard draw-up — size · concentration · color classPropofolInduction agent20 mL10 mg/mLFentanylOpioid3–5 mL50 mcg/mLMidazolamBenzodiazepine3 mL1 mg/mLLidocaineLocal anesthetic5 mL10 mg/mL (1%)SuccinylcholineDepolarizing relaxant10 mL20 mg/mLRocuroniumNon-depol. relaxant5 mL10 mg/mLNeostigmineReversal (+ glyco)5 mL1 mg/mLSugammadexReversal (roc/vec)2–5 mL100 mg/mLPhenylephrineVasopressor10 mL100 mcg/mLEphedrineVasopressor10 mL5 mg/mLGlycopyrrolateAnticholinergic3 mL0.2 mg/mL
swipe diagram horizontally →
Typical adult setup, induction → reversal. The colored band is the drug class (reversal agents are red with stripes); the size matches how much you'll give.
Pearls
  • Propofol comes in a 20 mL syringe because a 70 kg induction dose (~140 mg = 14 mL) plus titration fits perfectly.
  • Succinylcholine is 20 mg/mL — double rocuronium's 10 mg/mL — so the same volume is a very different dose. Read the label, not the volume.
  • Keep pressors in 10 mL syringes diluted to round numbers (phenylephrine 100 mcg/mL) so the math is instant in an emergency.

02The color-code system (ISO 26825 / ASTM)

Pre-printed anesthesia labels are color-coded by drug class so you can recognize a class at a glance — even upside down across the room. The color tells you the class, the text tells you the drug.

ColorDrug classExamples
YellowInduction agentsPropofol, etomidate, ketamine
OrangeBenzodiazepinesMidazolam
BlueOpioidsFentanyl, hydromorphone
Fluorescent redMuscle relaxantsRocuronium, succinylcholine, vecuronium
Red w/ stripesRelaxant antagonistsNeostigmine, sugammadex
VioletVasopressorsPhenylephrine, ephedrine, epinephrine
GreenAnticholinergicsGlycopyrrolate, atropine
Salmon/tanHypotensives / others(varies)
GreyLocal anestheticsLidocaine
The color is a backup recognition system. It does not replace reading the actual drug name. Two violet syringes (phenylephrine vs. epinephrine) are very different drugs.
Common mistakes
  • Trusting the color band alone — fluorescent red is both succinylcholine and rocuronium; you must read the text.
  • Using a generic blank label and scribbling — use the pre-printed class label whenever available.

03How to label — every time, no exceptions

Every syringe must carry: drug name, concentration, your initials, and date/time (and expiration for infusions). Label immediately after drawing up — before you set it down.

The discipline that prevents wrong-drug errors:

  1. Read the vial label when you pick it up.
  2. Read it again as you draw it up.
  3. Read it a third time as you discard the vial.
  4. Label before the syringe leaves your hand.

An ampoule of a paralytic and an antiemetic can look identical. The label and the triple-check are what stand between you and a never-event.

Pearls
  • Draw drugs up in a consistent left-to-right order on your tray so position itself is a second cue.
  • Propofol supports bacterial growth — strict asepsis and a 6–12 h expiration on the label.
Common mistakes
  • Drawing up several drugs and labeling them all at the end — that's exactly when two get swapped.
  • Borrowing a syringe a colleague drew up that isn't labeled. Discard it.

04Have your rescue drugs ready before you need them

Induction drops blood pressure. Don't wait for the hypotension to start drawing up a pressor.

Before induction, have drawn and labeled: - Phenylephrine 100 mcg/mL (bolus 50–100 mcg) - Ephedrine 5 mg/mL (bolus 5–10 mg) - Atropine/glycopyrrolate for bradycardia - Know where the emergency epinephrine and the code cart are.

For longer or sicker cases, also have your infusions spiked, primed, labeled with concentration, and loaded in the pump before the patient is asleep.