[Storing succinylcholine in prehospital settings following the recommendations of the French National Agency for the safety of medicines]

Abstract

Objective: The French National Pharmaceuticals Agency (ANSM) has recommanded in July 2012 not to break the cold chain before using succinylcholine (Celocurine®).

Research objective: to understand the pre-clinical evolution of the conservation modes of this curare.

Research type: Descriptive study before (year 2011) and after (year 2012).

Patients and method: Online survey to French Samu/Smur.

Data collected: SMUR location, conservation method at clinical base, in the mobile unit (UMH) and at the patient. Principal decision criteria: evolution of the conservation modes before and after the recommendation (qualitatives variables compared with a Fisher test).

Results: Out of 101 SAMU/SMUR, 62 answered. Conservation modes of succinylcholine vials were significantly different (P<0.001). Proper conservation was observed in 26 % of the cases before and 43 % after. Mobile units (UMH) equipped with a fridge increased from one out of two to 77 %. The lack of conservation modes passive or active on UMH went from 31 % to 3.4 % with isotherms bags with ice when a fridge was not available. The destruction of capsules at current temperature in a 24-hour period increased: 22 % before, 47 % after (P=0.04).

Conclusion: After recommendations from ANSM, conservation modes and destruction of succinylcholine in a prehospital environment were significantly impacted.

Keywords: Celocurine; Conservation; Crash induction; Célocurine; Effets secondaires; Induction en séquence rapide; Out-of-hospital; Préhospitalier; Side effects; Storage temperatures; Succinylcholine; Suxamethonium; Suxaméthonium.