Interfacility medication cooling insufficient

AMJ

Research published on the Air Medical Journal website on 29 July suggests that the current system of passive refrigeration of medications during interfacility transport may not effective. Study authors Jason Clancy, Cassandra Karish, Meghan Roddy and Michael Bigham of the Akron Children’s Hospital, and Judith Sicilia of Salem Health Department in Ohio, US, found that ‘the current system of passive refrigeration does not appear to be sufficient for safely storing medications or point-of-care testing equipment for our transport services’. In an article titled Temperature-sensitive medications in interfacility transport: the ice pack myth, the authors suggest that this might reveal a flaw in existing practices.

The aim of the study was to examine how effective current passive refrigeration is for transporting temperature-sensitive drugs and equipment. The researchers noted that critical care transport teams use various strategies to maintain items and equipment at their optimal temperature.

The authors tested various configurations and initial starting temperatures of transport cooler packs, measuring their performance with a thermal probe placed inside the packs to check the temperature was kept within the 2°C-to-8°C range. The average round-trip transport time of past missions they reviewed was 2.5 hours, while over 15 per cent of transports lasted longer than four hours. According to the study, with a starting temperature of −3.9°C, the cooler and ice pack maintained acceptable temperatures for three hours. When the ice pack starting temperature was −12.9°C, the set-up prevented overheating for almost seven hours, but the temperature fell 2°C in the first three hours. iSTAT cartridges remained within range for between one and four hours if the cooler and ice pack starting temperature was
-3.9°C, said the researchers.

In their conclusion, the authors state: “This study shows that the current model of passive refrigeration is ineffective, resulting in temperature excursions for commonly used medications and equipment. Further research in this area should focus on identifying a reliable strategy for maintaining medication/iSTAT temperature thresholds.”

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