Keeping blood and drugs cool on operations

The 'Golden Hour' container, produced by Minnesota Thermal Sciences, has completely revolutionised the delivery into operational theatres of temperature-sensitive medical materiel. Its name is based on the tenet that beating the effects of shock within the first hour of injury - by giving a blood transfusion, for instance - is vital to trauma patients' survival.

The life-saving container, a 12-inch-square (30cm-square) box, uses a combination of vacuum-insulated panels and an internal thermal insulating chamber containing a phase-change material to maintain the fridge-like temperatures required.

Warrant Officer Nick Woodward of the Medical and General Supplies Integrated Project Team said:

"The thermal chamber is placed in a freezer for approximately 18 hours to be conditioned. It's then removed and left at room temperature for 30 minutes, after which it's ready to be placed back in the container along with the supplies our defence medical staff have requested.

"Electronic devices are placed with each shipment to monitor the temperature at all times."

Although initially designed for blood, the beauty of this is that the container isn't just ideal for blood products but for anything that needs to be transported to medics, like vaccines and other temperature sensitive prescription medicines.

On arrival the electronic monitoring device provides a complete record of the internal temperature of the box during transit. Any transgression from the required shipping temperature will render the pharmaceuticals or blood unusable.

Temperature controlled storage for the movement of perishable medical material including blood and pharmaceuticals products has been a difficult challenge for the Medical and General Supplies team. For many years it required micro-management of consignments to the operational theatres of Iraq and Afghanistan, and non-operational theatres such as the Falkland Islands, Brunei and Belize, due to the range of temperatures: chilled, frozen, or UK ambient, and the inefficiencies of the technology available.

It utilised insulated tri-wall cases: charged polystyrene with wet ice, known as CIBIT and ACE boxes. They weren't very successful at maintaining the material temperature over the transit period or in storage. The failure of these medical supplies impacted on the customer and the team which managed them at a very high cost, but ultimately the end recipient.

To improve the situation, the team introduced Golden Hour technology to provide a more reliable, cost-effective and efficient capability.

Golden Hour technology products are simple, reusable, and thoroughly tested to meet specific applications. They eliminate the guesswork and complications of using wet and dry ice or gel packs and require no energy source.

Although they cost more than traditional containers, they represent only a fraction of the cost of the payloads they protect and can pay for themselves in reduced product failure, repeated usage and logistical flexibility.

The box has been tested and validated at extreme temperatures from minus 40 degrees Centigrade to +40 degrees centigrade by the Blood Supply Team of the Integrated Project Team and has shown to be effective for over 72 hours, depending on the ambient temperature.

Once the contents have been delivered, the boxes can be broken down into their component parts and returned to the UK through the Defence Supply Chain.

Their introduction into service has been welcomed by deployed specialist staff, too. Corporal J Kitching, Pharmacy Technician, Royal Army Medical Corps (RAMC), of 84 Medical Supply Squadron (Iraq Detachment), said:

"The introduction of the Golden Hour boxes has proved to be an invaluable asset to the medical supply chain. They ensure that temperature controlled items, which are packed at the main supply depot UK, are maintained within the correct temperature range and reach the destination of the second line supply depot without the need for boxes to be opened and re-iced at each step.

"This helps to minimise the risk of the integrity of the items being compromised and protects from the extreme heat and sun in both operational theatres."

And Major David Williams, a pharmacist with the RAMC, deployed in Iraq, said:

"These boxes are a marked improvement over the previous method of delivery for chilled pharmaceuticals. From a pharmacist's perspective there is now a much greater confidence that medicines, which need to be refrigerated, will reach the patient fit for use.

"These boxes have also reduced the wastage associated with re-demanding medicines which have exceeded their storage temperatures during delivery from the UK."

The Golden Hour containers are not just life-savers - as far as Warrant Officer Woodward is concerned, there are significant financial benefits too:

"We are saving significant costs a week because drugs and other products that previously we might have been forced to discard, because we couldn't always adequately control the internal temperature during their transit, are now arriving in excellent condition.

"The medical staff waiting at the other end of the process are getting the products they need, enabling them to save lives and provide the best possible medical care to our Armed Forces personnel."

This article is taken from the November 2008 edition of Desider - the magazine for Defence Equipment & Support.