Droplet Formation in Drugs During Extreme Temperature Conditions in the Emergency Medical Service, a Problem?

Objective: Because of high-altitude operations, cold exposure is common for helicopter emergency medical services. However, drug emulsions such as propofol and etomidate are prone to degradation and the formation of lipid droplets, possibly large enough to cause pulmonary embolism, when frozen. Amiodarone may be prone to crystallization, possibly causing phlebitis, when exposed to cold temperatures.

Stability of Drugs Stored in Helicopters for Use by Emergency Medical Services: A Prospective Observational Study.

Study Objective: Drugs stored in rescue helicopters may be subject to extreme environmental conditions. The aim of this study was to measure whether drugs stored under the real-life conditions of a Swiss helicopter emergency medical service (HEMS) would retain their potency over the course of 1 year.

Methods: A prospective, longitudinal study measuring the temperature exposure and concentration of drugs stored on 2 rescue helicopters in Switzerland over 1 year.