title: Can stock rotation effectively mitigate EMS medication exposure to excessive heat and cold?
abstract: The United States Pharmacopeia recently published a general chapter specifically addressing on-ambulance storage of medications, including a suggestion for stock rotation. This study describes the effectiveness of a simple stock rotation strategy in mitigating EMS medication exposure to excessive heat and cold. Previously collected on-ambulance temperature data from 5 US cities were randomly resampled to generate model exposures of 2 days to 6 months duration. The temperature measurements for every other 24-hour period were then set at 20 degrees C to model the rotation of medications into a controlled environment. For each model, we then determined consistency with the official United States Pharmacopeia definition of controlled room temperature. Without stock rotation, excessive heat occurred in 39.9% of the model exposures. With stock rotation, exposures to excessive heat occurred in less than 1% of northern city models and in 2.9% of the central US models. Stock rotation did not reduce heat exposures in the models for southern cities.
authors.affiliation: Department of Emergency Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USA. brownL@upstate.edu
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Brown
authors.forename: Susan M
authors.initials: SM
authors.lastname: Wojcik
authors.forename: Leonard C
authors.initials: LC
authors.lastname: Bailey
authors.forename: Calvin D
authors.initials: CD
authors.lastname: Tran
mesh_terms: D000552:Ambulances; D002151:Calorimetry; D003080:Cold Temperature; D004356:Drug Storage / Q000379:methods* / Q000592:standards; D019983:Guideline Adherence; D006358:Hot Temperature; D006801:Humans; D008956:Models, Chemical; D014481:United States