Temperature-sensitive Medications in Interfacility Transport: The Ice Pack Myth

Area of Science:

• Emergency Medicine
• Pharmaceutical Science
• Logistics

Background:

• Critical Care Transport (CCT) teams rely on passive refrigeration to preserve temperature-sensitive medications and equipment.
• Assessing the efficacy of these current passive refrigeration strategies is crucial for patient safety and treatment efficacy.

Purpose of the Study:

• To evaluate the effectiveness of existing passive refrigeration methods used by CCT teams for temperature-sensitive transport medications and equipment.

Main Methods:

• A retrospective analysis of transport durations was conducted.
• An experimental setup was designed using temperature probes in transport coolers with varying configurations and initial temperatures.
• Temperature margins were defined as 2°C (minimum) and 8°C (maximum).

Main Results:

• Average transport time was 2.5 hours, with over 15% exceeding 4 hours.
• At -3.9°C, coolers maintained "in range" temperatures for 3 hours; at -12.9°C, temperature excursions occurred after 6 hours 55 minutes.
• iSTAT® cartridges remained within the required temperature range for only 1-4 hours when starting at -3.9°C.

Conclusions:

• Current passive refrigeration systems are inadequate for safely storing medications and point-of-care testing equipment during CCT.
• This highlights potential deficiencies in current transport medication refrigeration practices.