Clancy Jason, Karish Cassandra, Roddy Meghan, Sicilia Judith J, Bigham Michael T
Division of Emergency Medicine, Akron Children's Hospital, Akron, OH.
Department of Pharmacy, Akron Children's Hospital, Akron, OH.
Air Med J. 2017 Nov-Dec;36(6):302-306. doi: 10.1016/j.amj.2017.05.002. Epub 2017 Jul 29.
Critical Care Transport teams use various strategies to maintain temperature sensitive drugs and equipment at optimal temperature. The purpose of this study was to examine the effectiveness of current passive refrigeration of temperature sensitive transport medications/equipment.
Initially, we performed a retrospective review of transport durations. Subsequently, an experimental paradigm was created using a temperature probe inside of the transport cooler packs utilizing various configurations and initial starting temperatures with high and low "in range" temperature margins of 8°C (max) and 2°C (min).
The mean round-trip transport time was 2.5 hours and over 15% of transports last longer than 4 hours. At a starting temperature of -3.9°C, the cooler and ice pack maintained "in range" temperatures for 3 hours. When the ice pack starting temperature was -12.9°C, high temperatures excursions weren't experienced until 6 hours 55 minutes, but initially low excursions fell below for up to 3 hours. iSTAT cartridges remained within range between 1-4 hours at cooler and ice pack starting temperature of -3.9°C.
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. This might reveal a flaw in the existing practices around medication refrigeration in transport.
重症监护转运团队采用多种策略将对温度敏感的药物和设备维持在最佳温度。本研究的目的是检验当前对温度敏感的转运药物/设备的被动制冷效果。
首先,我们对转运时长进行了回顾性分析。随后,利用温度探头在转运冷却包内创建了一个实验范式,采用各种配置和初始起始温度,“温度范围”的高值和低值分别为8°C(最大值)和2°C(最小值)。
往返平均转运时间为2.5小时,超过15%的转运持续时间超过4小时。在起始温度为-3.9°C时,冷却器和冰袋在3小时内维持“温度范围”内的温度。当冰袋起始温度为-12.9°C时,直到6小时55分钟才出现高温偏差,但最初的低温偏差在长达3小时内低于温度范围。在冷却器和冰袋起始温度为-3.9°C时,iSTAT血糖仪试纸条在1 - 4小时内保持在温度范围内。
当前的被动制冷系统似乎不足以安全储存我们转运服务中的药物或即时检验设备。这可能揭示了转运中药物冷藏现有做法中的一个缺陷。