A prospective descriptive study on emergency medicines used most frequently from the emergency medicine packs at Universitas Academic Hospital and the associated financial loss of expired emergency medicines

Resuscitation trolleys with equipment and medicines for emergencies are required in all clinical areas in hospitals. Emergency medicines kept separately are more likely to expire than non-emergency medicines, as these are generally used less frequently. An updated list of essential emergency medicines was implemented in 2016 at an academic hospital in central South Africa. The aim of this study was to determine the frequency of both the use and the expiry, with associated financial losses, of the emergency medicines on this list. Methods: A prospective, descriptive study was conducted over a six-month period in 2019. Forms accompanying the emergency packs were returned to the pharmacy whenever packs expired or were opened. These forms were collected and the type and quantity of medicines either used or expired were recorded. Results: In total, 168 of the returned forms were included. The most frequently used emergency medicines were adrenaline, sodium bicarbonate and Ringer's lactate. Adrenaline use was recorded on 52.8% and 25% of the forms from the adult/paediatric and neonatal emergency packs, respectively. Medicines that were never used included: betamethasone, Darrow's half-strength solution and most of the neonatal pack medications. Neonatal emergency medicine packs were rarely used and the neonatal fluid packs were never used. The total cost of the expired medicines was R7 960.29 (US$569.41 at the time of the study). Adrenaline was the medication that expired most frequently but the greatest financial losses occurred from expired sodium bicarbonate. Conclusion: The total financial losses were low but can be reduced further. The contents of the emergency packs should be reviewed to possibly reduce the amount of items used infrequently. Also, the removal of those items not recommended in emergency care guidelines could be considered. Ensuring the policy was followed of returning unused medicines close to expiry and redistributing these to high-use areas would further reduce wastage

Nébulisation SSH 3% versus adrénaline ou salbutamol au cours de la bronchiolite aiguë du nourrisson au Centre Hospitalier Universitaire Mère enfant Ambohimiandra

Introduction : l'incidence de la bronchiolite est en augmentation constante dans notre hôpital. De multiples études ont été effectuées sur les molécules à utiliser pour l'aérosolthérapie pour améliorer la prise en charge de la bronchiolite. L'objectif de cette étude était de comparer l'efficacité du SSH 3% versus salbutamol et adrénaline. Méthodes : il s'agissait d'une étude comparative menée sur une période de sept mois au Centre Hospitalier Universitaire Mère Enfant Ambohimiandra, incluant tous les nourrissons de 29 jrs à deux ans admis pour bronchiolite. Les aérosols ont été effectués tous les 3 heures pour chaque groupe de population. L'efficacité de chaque molécule à partir des scores cliniques de Wang et RDAI, la fréquence cardiaque, et la SaO2 ont été évaluées. Résultats : au total 122 nourrissons ont été inclus. 60 avaient moins de trois mois dont 30 étaient sous SSH 3 % et 30 sous adrénaline, 62 avaient plus de trois mois dont 31 étaient sous SSH 3% et 31 sous salbutamol. Une amélioration nette du score clinique RDAI dès la H12 (p=0.01), de la fréquence cardiaque dès la H24 (p=0.01), et de la SaO2 dès la H1 (p=0,004) ont été observé chez les nourrissons moins de trois mois sous SSH 3%. Il n'y pas eu de différence avec celui du salbutamol Conclusion : la SSH 3% était plus efficace que l'adrénaline dans le traitement de la bronchiolite aigue chez les nourrissons moins de trois mois