Learn how to prevent vial coring when piercing a rubber stopper of a vial with a needle.
What is vial coring and does it present a problem for the patient?
Vial coring can occur when a needle is used to pierce a vial’s rubber stopper. Coring occurs when parts of the rubber stopper enter the vial’s contents. These small pieces can be withdrawn from the vial during the draw up of the medication and may potentially be injected into the patient. If coring does occur, sometimes the pieces can be so small you won’t be able to see them with your eyes.
However, to help decrease coring from happening the following technique can be performed:
Vial Coring Prevention Technique
1. Wash hands and gather supplies: syringe with needle attached, alcohol prep, vial
2. Flip off top of vial, if needed.
3. Scrub the vial’s rubber stopper with alcohol prep for 30 seconds before penetration of the stopper.
4. Instill air in the syringe, if needed. More for information on this step, please see the review on how to withdraw medications from a vial.
4. Note the bullseye design of the stopper. You’re aiming for the middle part of the rubber stopper with the needle.
5. Hold the barrel of the syringe at a 45 degree angle with the bevel of the needle positioned upward in the center of the bullseye (the bevel is the opening of the needle’s tip).
6. Apply pressure to the needle tip and as the needle begins to penetrate the stopper push down while simultaneously rotating the needle to a 90 degree angle in one smooth motion.
7. Lastly, inject the air from the syringe into the vial’s space of air, if needed.
More Nursing Skills
Medication Preparation Questions | Injection Safety | CDC. Cdc.gov. (2021). Retrieved 20 January 2021, from https://www.cdc.gov/injectionsafety/providers/provider_faqs_med-prep.html.Roth, J. (2007).
How to Enter a Medication Vial Without Coring. Anesthesia & Analgesia, 104(6), 1615. https://doi.org/10.1213/01.ane.0000260552.76585.53