American Journal of Emergency Medicine
Volume 26, Issue 5 , Pages 566-573, June 2008

Alteration in prehospital drug concentration after thermal exposure☆

  • Dustin L. Gammon, CCEMT-P

      Affiliations

    • St. John's Emergency Medical Services, Springfield, MO 65804, USA
    • Department of Chemistry, Missouri State University, Springfield, MO 65897, USA
    • Corresponding Author InformationCorresponding author. St. John's Emergency Medical Services, Springfield, MO 65804, USA.
    • ,
  • Shujun Su, PhD

      Affiliations

    • Department of Chemistry, Missouri State University, Springfield, MO 65897, USA
    • ,
  • Roger Huckfeldt, MD

      Affiliations

    • St. John's Trauma Services and Research Department, Springfield, MO 65804, USA
    • ,
  • Janet Jordan, MD

      Affiliations

    • St. John's Emergency Medical Services, Springfield, MO 65804, USA
    • ,
  • Robert Patterson, EMT-P

      Affiliations

    • St. John's Emergency Medical Services, Springfield, MO 65804, USA
    • ,
  • Phillip J. Finley, MS

      Affiliations

    • St. John's Trauma Services and Research Department, Springfield, MO 65804, USA
    • ,
  • Cindy Lowe, BS, CCRP

      Affiliations

    • St. John's Trauma Services and Research Department, Springfield, MO 65804, USA

Received 14 August 2007; received in revised form 8 September 2007; accepted 9 September 2007.

Abstract 

Objective

The aim of the study was to determine the remaining concentration of 23 commonly carried emergency medical services medications used in the United States after they have experienced thermal extremes that have been documented in the prehospital environment for a period of 1 month.

Methods

Pharmaceuticals were thermally cycled (−6°C and 54°C) every 12 hours and then assayed by high-performance liquid chromatography.

Results

Eight (35%) of 23 prehospital pharmaceuticals revealed ending concentrations of less than 90% with strong correlation to thermal exposure time. These included lidocaine, diltiazem, dopamine, nitroglycerin, ipratropium, succinylcholine, haloperidol, and naloxone.

Conclusion

A decrease in concentration was found to be statistically significant in 8 (35%) of 23 commonly carried emergency medical services pharmaceuticals. These results provide new information and perspective regarding stability of emergency drugs in the prehospital environment by evaluating a broad range of pharmaceuticals as well as by using thermal exposure points that have been documented in the United States.

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☆ Funding sources: This project was funded by St John's Emergency Medical Services and St John's Trauma Services. Additional cost coverage provided by the author; instrument utilization, supervision, and consultation, provided by Missouri State University.

 Prior presentation: This project was presented in poster form at the 21st Annual Combined Clinical Conference on Emergency Care, Osage Beach, Mo, August 8-10, 2007.

PII: S0735-6757(07)00596-7

doi:10.1016/j.ajem.2007.09.004

American Journal of Emergency Medicine
Volume 26, Issue 5 , Pages 566-573, June 2008

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