Temperature control of drugs in cars

Re: Temperature control of drugs in cars

bob lehner — Mon, 04 Apr 2011 13:30:54 GMT

Thanks Alex - useful info. Unfortunately the data logger which seems to be in in common use doesn't incorporate an alarm or warning light.

Re: Temperature control of drugs in cars

Michael Woodhouse — Mon, 04 Apr 2011 13:25:27 GMT

[quote user="Alex Allen"]If your DIY skills are good then pop down to your local builders merchant and get some insulation material such as Celotex and build an insulated box for all your drugs - this type of insulation should keep temperatures consistent even in the height of summer. Polystyrene boxes used to transport laboratory supplies also make good cool boxes - look for insulation 30mm or thicker.[/quote]

I am familiar with solid board insulation and it's too bulky. At 50mm thick a box of sufficient size to store a couple of boxes of TMPS granules and a few tubs of the respiratory powders would be quite some size! I have no spare room in my car as it is, never mind taking up precious space with insulated boards.

What are we supposed to do in summer when the surgery gets up to 30°C? Throw everything out? Our deliveries come in normal Transit type vans. It's going to have to be like the 28 day rule for me - I'll do my best but 100% compliance is not possible/financially feasible. The only solution to store everyting is a refrigerated van.

Re: Temperature control of drugs in cars

Alex Allen — Mon, 04 Apr 2011 11:36:54 GMT

Several data loggers will indicate the current temperature is still within a set range by either an audible or visual alarm. Temperatures are recorded every few seconds or every few minutes (set via the software) so they are practically "live".eg a red LED light flashes if the range is exceeded.

If a person opens the fridge for a few minutes whilst stocking up then a max thermometer marker may then read over the 8C and hence the recording chart will show a max temp in excess of 8C - Have the drugs been compromised? As a drug company if we are asked by a practice if their fridge contents can be saved one of the first questions I will ask is "How long were the drugs exposed to the elevated temperature?"

With max-min therm there is no knowledge of this and hence we cannot advise on the stability or viability of vaccines etc. With a logger if it can be shown to be only whilst the door of the firdge was open then obviously the contents can be saved. Temperature recovery is an important feature of pharmaceutical grade fridges with "booster" systems to quickly correct back to an appropriate temp - something that cheap chillers may not manage especially if opened repeatedly during the course of a busy surgery.

Accuracy of the thermometer must be checked - some cheap ones will have errors of at least +/- 2C. I've checked one thermometer in the past and it was reading 5C out from my thermocouple with a certified error of +/- 0.5C.

Re: Temperature control of drugs in cars

bob lehner — Mon, 04 Apr 2011 11:09:28 GMT

[quote user="Alex Allen"]

We recommend using temp data loggers rather than max/min thermometers as these will provide better information over periods of time and give a better indication of what temperatures the drugs are subjected to.

[/quote]

Isn't the problem with data loggers that they look retrospectively at temperatures to which the drugs were exposed ?

Surely you really want to know what the temperature is at the current moment. I have this discussion with practices over fridge monitoring - you don't really want to know that your vaccine fridge was running too high a week ago - by then it's too late to do anything about it ?

Re: Temperature control of drugs in cars

bob lehner — Mon, 04 Apr 2011 11:09:28 GMT

[quote user="Alex Allen"]

[/quote]

Isn't the problem with data loggers that they look retrospectively at temperatures to which the drugs were exposed ?

Re: Temperature control of drugs in cars

Alex Allen — Mon, 04 Apr 2011 11:00:28 GMT

As mentioned above there are various mobile mini coolers and fridges that can operate off a car's 12V and mains 240VAC. Worth checking the spec of these coolers as some of the cheaper ones won't reach 2-8C when the ambient temperature exceeds 25-30C - which in summer could be a concern.

Camper van fridges cool via a different system that is slightly more robust BUT they do produce heat - brands like Dometic are famous for the camping van fridges. Dual battery systems as mentioned previously are useful to run these 24hrs.

Waeco make several mobile fridges which have been used by LA vets / mobile medical teams and will operate happily in UK climes.

If your DIY skills are good then pop down to your local builders merchant and get some insulation material such as Celotex and build an insulated box for all your drugs - this type of insulation should keep temperatures consistent even in the height of summer. Polystyrene boxes used to transport laboratory supplies also make good cool boxes - look for insulation 30mm or thicker.

Re: Temperature control of drugs in cars

Rob Loxley — Fri, 01 Apr 2011 22:49:20 GMT

[quote user="Wren"]But you see my problem lies not with the refridgerated items (I have a mini fridge ordered for them and drive ~110 miles/day in short frequent trips) but with the rest.[/quote]

An insulated coolbox would probably do a reasonable job of insulating against heat, why not stick a max/min thermometer in and see.

Or alternatively just a bigger fridge - you can get 50 litre fridges that run on 12V power

Re: Temperature control of drugs in cars

Wren — Fri, 01 Apr 2011 12:42:20 GMT

But you see my problem lies not with the refridgerated items (I have a mini fridge ordered for them and drive ~110 miles/day in short frequent trips) but with the rest. I usually have a box of Danilon, a box of bute, 2 boxes of Norodine granules, a tub each of Ventipulmin and Sputolosin, various wormers plus all the non-refridgerated injectables such as Flunixin/Alamycin/Draxxin/Metacam....... etc. etc.

The data sheets for almost all these products say 'store below 25C' yet I'd struggle to get them all into my kitchen fridge, let alone install a car fridge large enough for them. It wasn't a problem until we started recording temperatures but surely recording a temperature which is too high on a daily basis is worse than not recording one at all!

Re: Temperature control of drugs in cars

Clive Ansell — Fri, 01 Apr 2011 12:26:40 GMT

[quote user="Michael Woodhouse"]

The problem with these cool boxes [as I see it] is they only run when the engine does. Even on a busy day I'm rarely driving for more than an hour and a half per day - sometimes a lot less. You'd need to power it at other times to be of much use.

They seem to be a token gesture at best.

[/quote]

Not always. It doesn't work in my present car (Peugeot 207) with engine off, but it did in my old one (Peugeot 306). if not, It is fairly straight forward to wire the 12v jack so that it is always powered regardless of whether or not ignition is on - although be careful not to run the battery down if on too long.

I will put a thermometer in mine next time I use, but it is a good piece of kit. I've kept perishable food in it for 5 - 7 days before and it has been fine.

Re: Temperature control of drugs in cars

Laurence Webb — Fri, 01 Apr 2011 11:47:29 GMT

My copy of Veterinary Practice dropped through the door today with a load of adverts for fridges (including in-car ones) from Shoreline. Suspect a Camping Gaz one would be a cheaper, if less reliable, option.

Re: Temperature control of drugs in cars

Gillian Mostyn — Fri, 01 Apr 2011 09:58:33 GMT

[quote user="Michael Woodhouse"]Has ANYONE EVER experienced lack of efficacy from a product kept too warm in a car?[/quote]

Who knows? Wouldn't you rather not risk it?

If an animal has an adverse reaction (or no reaction) to a drug, you're going to have a hard time discussing/defending that if the bottle was kept at 50 degrees C!!!

Re: Temperature control of drugs in cars

Gillian Mostyn — Fri, 01 Apr 2011 09:55:43 GMT

The camping fridge we have also runs off the mains. I would assume that if you put a couple of cool packs inside and make sure you plug it in at night, and make sure you keep it shut, it would be fine only running intermittantly during the day. Got to be better than nothing anyway!

The one we've just bought will run when the engine is off but has a shut off facility if the car battery is becoming depleted. They do exist.

Incidentally, these camping fridges wil heat as well as cool so can be very useful in the winter too!

Re: Temperature control of drugs in cars

Tim Cheyne — Fri, 01 Apr 2011 07:38:27 GMT

When working upcountry overseas I had a frig/freezer in my landrover that could operate from 12vDC, 230v AC mains and bottled gas! I never used the gas option but during the day it operated on 12vDC and at night from a long lead plugged into the mains. The possibility of depleting the car battery worried me so an Aussie ex-service mechanic fitted a split alternator kit that allowed two batteries to be charged when the engine was running, one, as usual, for the vehicle and one for the refrigerator. When the vehicle was stationary (on ferries etc or sites without mains electricity) the separate battery kept the frig running for more than ten hours without depleting the car battery. This was in Bangladesh where the temperatures (especially in an uninsulated landrover can be quite high). The frig operated quite satisfactorily during the four or more years that I had that vehicle; carrying medicines, vaccines and some food items on the outward journey and samples when returning.

I had seen similar refrigerators in use in East Africa and, browsing the car accessories shops here, I think that they are available in the Gulf so they can probably be found in UK. Are they fitted in UK emergency vehicles such as ambulances?

Tim.

Re: Temperature control of drugs in cars

Michael Woodhouse — Thu, 31 Mar 2011 23:38:58 GMT

They seem to be a token gesture at best.

Re: Temperature control of drugs in cars

Joyce Whitehead — Thu, 31 Mar 2011 22:32:36 GMT

We have plug in cool boxes (designed for campers) in the LA vets' cars - they are insulated and are actively chilling when the cars are running, and seem to satisfy the PSS inspector. All temperature sensitive drugs are kept in them, and only enough to cope with the day's activities (plus a bit extra as needed).

We bought them in Halfords when they were on offer, and they were not particularly expensive as I remember - plug in to the cigarette lighter socket.

Re: Temperature control of drugs in cars

Clive Ansell — Thu, 31 Mar 2011 21:22:52 GMT

I have a Camping Gaz fridge box I use in my car that plugs in to a 12 volt jack, for food not for veterinary use. It must be 25 years old, works great, but has no min/max thermometer. Beers are always just right, so guess temperature must be ok to satisfy the box tickers.

Re: Temperature control of drugs in cars

Gillian Mostyn — Thu, 31 Mar 2011 20:28:46 GMT

You can get pretty big car/camping fridges these days...what about one of those?

Re: Temperature control of drugs in cars

Michael Woodhouse — Thu, 31 Mar 2011 18:53:17 GMT

I keep bottles in the polystyrene trays in 2 draws in wooden boxes. This gives a degree of protection when the temperature suddenly climbs. Don't keep vaccines in the car, just take them out when needed. I can assure you that in summer my oxytocin that must have been at 50 degrees seems to still work!

What about a picnic cool box to smooth fluctuations? This is one of those things there is no real answer to, other than complete fitted refrigeration (needs plugging in to the mains at night).

Maybe I should also post under an alias?

Has ANYONE EVER experienced lack of efficacy from a product kept too warm in a car? [not good for mercury thermometers!]