Harmonization and Standardization of Drugs Supplied to the Advanced Rescue Means of the EMS in Lombardy
Abstract
Harmonization and Standardization of Drugs Supplied to the Advanced Rescue Means of the EMS in Lombardy
Authors
ESTENSORI E. Perego**, G.F. Villa*, P. Minghetti** COADIUTORI C. Frigerio*, A. Brancaglione*, S. Campi*, S. Zerbi*, A Calini*, A. Mariotti*, L. Colombi*, F. Kette*, O. Valoti*, A. Andreassi* * AREU Lombardia ** Università degli Studi di Milano
Background
Drugs supplied for advanced rescue means of AREU.
Design and setting
Observational, retrospective, analytical, single cohort study on drugs supplied to the advanced rescue means (ARM) of the Lombardy region.
Objective
Regional analysis and subsequent standardization of mandatory drugs supplied to the Advanced Rescue Means (ARM) in Lombardy.
Methods
A retrospective analysis related to the quality and quantity of drugs administered by the AREU 118 (EMS) staff to the adult population in emergency situations showed a very diverse regional situation. The need to draft a standardized list of drug supplies followed specific criteria: drugs commonly used in most provincial EMS', data related to specific scientific literature, validated, practical rescue experience, guidelines of the Italian Society EMS Systems (SIS 118). The individual drugs were evaluated for one year by a specific AREU study group that drafted appropriate data sheets.
Results
The final standardized list of medications included 71 drugs that were selected for advanced rescue by ARM. The examination of their storage conditions, which was done in order to optimize their management, highlighted the six most critical drugs (adrenaline [1 mg / 1 mL], adrenaline [5 mg / 5 mL], insulin, oxytocin, rocuronium and succinylcholine). These drugs need to be stored at a temperature between 2 ° C and 8 ° C, and have to be kept in the refrigerator of the rescue stations and in appropriate refrigerated containers on board the ARM.
Conclusions
The choice of a single, standardized drug list supplied at regional level for the ARM offers obvious advantages in terms of unified patient treatment based on the same guidelines and staff training. This choice also allows better control of consumption and costs, ensuring the unique management of the drugs and the critical aspects of their storage.