Pharmacy Department, Medical and Health Directorate, National Fire and Rescue Corps (Corps grand-ducal d'incendie et de secours, CGDIS), Luxembourg, Luxembourg.
Department of Analytical Toxicology, Pharmaceutical Chemistry Service, Laboratoire National de Santé Dudelange, Luxembourg.
Ann Emerg Med. 2022 Oct;80(4):358-363. doi: 10.1016/j.annemergmed.2022.05.001. Epub 2022 Jun 16.
Drugs in emergency medical service (EMS) cars are often exposed to temperature variations that could affect the stability of these drugs. We aimed to study the influence of real-life temperature exposure on the stability of 5 drugs onboard an EMS vehicle.
Concentrations of active principles of 5 emergency drugs (amiodarone, rocuronium, fentanyl, succinylcholine, and epinephrine) aboard an EMS vehicle were analyzed every 3 months up to 1 year. The samples were compared to the same drugs stored for 1 year either at room temperature or in a refrigerator in the pharmacy. Succinylcholine was additionally analyzed once a week for 4 weeks after being taken out of the refrigerator. The dosage of the active principle was measured using high-pressure liquid chromatography coupled with ultraviolet detection.
After the 12-month period, all drugs from the EMS car, except succinylcholine, presented concentrations still above 90% of the concentrations measured at the start of the project. Concentrations ranged from 96.3% to 103%. For succinylcholine at 12 months, the remaining concentration was 89%. Temperatures in the EMS car ranged from 13.9 °C to 33.9 °C (median, 22.8 °C [interquartile range, 20.5 °C to 25.8 °C]).
In real-life conditions, amiodarone, rocuronium, fentanyl, succinylcholine, and epinephrine onboard an EMS vehicle did not suffer pharmacologically relevant degradation from temperature variations. All concentrations measured remained in the specification intervals given by the manufacturers.
急救医疗服务（EMS）车内的药物经常暴露于可能影响这些药物稳定性的温度变化中。我们旨在研究现实生活中的温度暴露对EMS 车内 5 种药物稳定性的影响。
每隔 3 个月对 EMS 车内的 5 种急救药物（胺碘酮、罗库溴铵、芬太尼、琥珀酰胆碱和肾上腺素）的有效成分浓度进行分析，直至 1 年。将这些样本与在室温下或在药房冰箱中储存 1 年的相同药物进行比较。琥珀酰胆碱在从冰箱中取出后还额外每周分析一次，共 4 周。使用高压液相色谱法结合紫外检测法测量有效成分的剂量。
经过 12 个月的时间，除了琥珀酰胆碱外，EMS 车内的所有药物的浓度仍保持在项目开始时测量值的 90%以上。浓度范围为 96.3%至 103%。在 12 个月时，琥珀酰胆碱的剩余浓度为 89%。EMS 车内的温度范围为 13.9°C 至 33.9°C（中位数为 22.8°C[四分位间距为 20.5°C 至 25.8°C]）。
在现实生活条件下，EMS 车内的胺碘酮、罗库溴铵、芬太尼、琥珀酰胆碱和肾上腺素不会因温度变化而发生药理相关的降解。测量的所有浓度均保持在制造商规定的规格区间内。
