hey everyone it's Sarah register nurse aan.com and in this video I'm going to demonstrate for you how to crush a medication when you're giving it through a tube feeding or orally so what is the purpose of why we Crush medications well number one if a patient has a tube feeding we need to crush the medication into a fine powder so we can instill it through the tube so it can get to the stomach or the patient just has trouble swallowing big pills they get choked on them so um we have to crush it and either mix it in water or some type of food like applesauce so let me demonstrate for you how to do this through for a tube feeding or orally and then I'm going to follow up with some tips of some things you want to keep in mind whenever you're doing this skill okay first let me demonstrate for you how to crush a medication to give through a tube feeding okay first before you do this you always want to follow your hospital protocols and how much water you will be giving before you give a medication in between medications and after medications because um each hospital has a strict protocol on what you follow for tube feedings for Med for medication administration and um the following supplies you will need you will need a pill crusher whatever you have access to you will need a medicine cup because you will um be putting the medication in that after you crush it into a fine powder you'll need a 60cc syringe interal syringe that will connect to the patient's tube so you can easily give the medication and um you'll need warm water per peel about 20 CC of warm water that you'll mix each medication in to give and then you'll need a pair of gloves and of course before you do this you do hand hygiene and always put your gloves on whenever you are crushing medications because um you're breaking these medications down into where the chemicals are and you do not want to get these on your skin they can be dangerous okay so you're going to get your pill crusher make sure you have the the right medication the right patient check everything off before you um start doing this and for this particular Crusher you just stick the medication in the bottom and we put this on top and then we just twist it and as we do this it starts to crush the medication and you twist it until it can't go anymore and then untwist it and then I just try to get that residue off at the end so you're making sure you get all the medicine in there and I like to just wipe it in there and then empty it into your medicine cup you got to make sure it doesn't stick on the sides especially if you're using one of these kind of twist type Crushers okay then what we're going to do is we are going to instill some water in our medicine cup and mix it up really good and then we'll draw it up and just stir it because you want everything stirred up very well so it doesn't stick in your tube and cause your tube to become clogged because a clogged tube is no fun for you or the patient and um you will crush each pill separately you never Crush medications together because when you crush them together it will break down that protective coating and those chemal will mix together and um affect their ability to work it can decrease their effectiveness and then you're just going to draw up with your syringe medication and sometimes it likes a settle at the bottom so you've really got to stir it to make sure you can get it all up in there okay and I like to get the air out of my syringe slowly push it up there put your cap back on and then you're ready to instill that into the tube and you'll give that and then flush behind it and then repeat your next medication and if you were using a type of Crusher like this you would need to clean all the residue off wash it with warm soap and water before you do the next medication cuz you don't want to mix medications and that goes for if you're going to be using this for another patient now let me show you how to crush medicines to give orally okay um with this what you can do is you'll mix the medication with either water or here we're going to use applesauce a tip is not to use a patient favorite food or something on their food tray that they're going to be eating like green beans or something like that because these medications when crushed taste horrible and you don't want to ruin the patient's food so um what you're going to do is you need to get your pel Crusher you need to get some applesauce if that's what you're going to use to mix it in a spoon get the right peel for the right patient and then your gloves and of course before you do this perform hand hygiene and put your gloves on and put your pill in your pill crusher and use your pill crusher according to how you're supposed to use it and again you crush pills individually because you don't want to mix them together because they can affect how they work and typically what I like to do is I like to use one spoonful of applesauce per pill and then just repeat with however many pills I have because you don't want to mix one pill and a huge thing of applesauce cuz one cuz if you have to give three more pills that's a lot of applesauce that patients going to be eating so try to use the smallest amount of applesauce as possible so you don't fill your patient up so we're just going to put it in there and be careful you get all of the contents in there okay and remember you will clean your pill crusher in between medications and in between patients if um you're not using a close system Crusher and you will mix this up try to mix it up as good as you can so um patients aren't getting big chunks of pills in their mouth and once you have it mixed good administer that to the patient and then repeat as necessary now let me give you some quick tips to remember whenever you're crushing medications tip number one remember that not all medications can be crushed and if you're ever unsure if a medication can be crushed or not always call Pharmacy because they're great um in helping you determine if you can crush it or not and as a nurse whenever you work over time you get experience you will learn what you can and can't crush and another thing is to look at the medications name because a lot of medications they will have the name and then they'll have these letters after the name like detrol la la stands for long acting you can't Crush that and there's typically five categories of drugs that you cannot crush and they are inter coded long acting extended release controlled release SL delivery or sustained release SL action and to help you remember those five categories of drugs remember this pneumonic seniors erroneously Crush inter coded laxatives and this will help you to remember it because a lot of times patients who are taking Crush medications are your seniors your elderly patients and seniors the ration for seniors is Sr so that's sustained release um erroneously e is for extended release Crush CR is for controlled release and then anic cated is for anic cated and then laxatives is for La which is long acting and the last tip is to try to consult with the physician or the pharmacist on trying to get the medication switched to a liquid form or an IV form so the medication doesn't have to be crushed and um that may be possible if your patient just doesn't like swallowing their pills and they rather have it in a liquid form but if your patient requires like nectar thick liquids or honey thick liquids that they may not be a candidate but always just try to consult with uh other parts of the team to see if you can help the patient out okay so that wraps up this demonstration on how to crush medications thank you so much for watching and don't forget for get to subscribe to our channel for more videos