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National Drug Shortage Puts Patients at Risk

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Lives at Stake
Unexpected shortages of life-­saving drugs are putting lives at stake in emergency departments and ambulances across the country.

“This is something that has never existed and never had to be considered in the past,” says JEMS Editorial Board member and Medical Advisor for Washington Township (Ohio) Fire Department James Augustine, MD, FACEP. “Now it’s becoming frequent.”

As of press time, there were reported shortages of such drugs as Ondansetron/Zofran, Dopamine and epinephrine. “This is uncharted territory,” says Augustine.

The Food and Drug Administration (FDA) held a meeting on the topic in September. A record-high 178 drug shortages were reported in 2010, according to the FDA. And the numbers in 2011 are growing.

“There is no quick solution that solves this critical public health issue; addressing it will require a multi-faceted approach,” FDA Commissioner Margaret Hamburg, MD, and Assistant Secretary for Health Howard Koh, MD, said in a joint statement.

Shortages have been attributed to manufacturing problems, unanticipated demand and companies discontinuing older products in favor of newer, more profitable ones. Officials at the September meeting suggested creating a way for drug makers to notify the FDA earlier of impending problems, which would get that information out faster.

“We have had significant shortages of epinephrine, which is a life-saving drug,” Augustine says. “If it’s not available, lives are at stake.”

Although manufacturing issues are always a concern, Augustine suspects financial reasons are likely the cause of the backups.

“I’m quite afraid,” Augustine says. “This is an unprecedented problem that comes without an explanation and seemingly occurred without the suppliers [being] willing to take accountability.”
—Richard Huff, NREMT-B

CO-Detecting Cell Phone
Three years down the road, it’s possible every cell phone sold in the U.S. could be part of an elaborate emergency detection system, thanks to a new program from the Department of Homeland Security (DHS).

The Cell-All Initiative, spearheaded by the DHS Advance Research Products Agency, aims to build a network of tiny sensors in smartphones that would detect dangerous gases and chemicals and alert officials of pending risks.

“In its greatest manifestation, everyone would have it,” says Stephen Dennis, Cell-All’s program manager.

The concept is simple. Cell phones would continuously monitor for deadly chemicals, much the way home smoke detectors do. If a chemical were detected, it would send a signal to emergency officials. EMS responders would then know what they’re facing.

Cell phone makers are working with the DHS and expect to have a test phase in 18–20 months, says Dennis.

The sensors’ findings would be anonymous, so officials would get only a location and type of reading. Owners of the phones would also have to opt-in to activate the service.

The sensors are expected to be capable of reading four or five chemicals. It’s possible, Dennis says, that some phones could measure for one set of information, while others search for different ones, creating a wider net. All would search for carbon monoxide.

“In my mind, it will save lives in the first year just on carbon monoxide issues alone,” says Dennis. “Using this sensing out to the edge of the network, this would actually make that kind of safety ubiquitous.” JEMS
—Richard Huff, NREMT-B

In Brief:
To read more about the national drug shortage, visit www.jems.com/patient-care in December.

This article originally appeared in November 2011 JEMS as “Lives at Stake: National drug shortage continues.”



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