Previous posts have covered the shelf life of medications. The vast majority of medications, over 90%, are still very effective even years beyond their expiration date. But what about all the other medical supplies? Most of them also have expiry dates stamped on them, everything from the alcohol swabs to the sutures and sterile gloves. Ultimately, you have to be pretty happy that you didn't use these supplies. You experienced the peace of mind of having them if needed, without actually ever using them. It's a huge win-win. But you've got all these supplies. Some of them were pretty expensive. And now you're wondering, are they still safe to use?
Wonder no more. Let's take a look at expiry dates for these supplies and what they really mean.
First we'll consider the sterility of supplies. Kelly Pyrek noted in an article nearly twenty years ago that
"a Canadian nurse was rummaging around in her hospital's basement and discovered a trunk containing old bandages wrapped in muslin that she suspected had been packaged for shipment overseas during World War II. Curious as to what effect more than 50 years of storage would have on these once-sterile dressings, the nurse brought the bandages to the laboratory for testing. The packages were cultured and no microbial growth was found. This discovery helped convince several hospitals in British Columbia to convert from time-related sterility protocol to event-related sterility (ERS) protocol without clinical mishap and with improved cost savings."
Just because supplies are old, it doesn't mean they are no longer sterile. Supplies like sutures, staplers, and gauze are packaged in plastic or sometimes paper to keep them sterile. Theoretically, they'll still be sterile in 20 years. However, medical supplies need a little extra care to keep them sterile. They need to be kept dry and clean. While dropping a suture package on the floor doesn't directly contaminate the suture, any microbes that the package picks up from the floor can easily be transferred when the suture package is opened. Likewise, packages shouldn't be handled any more than is absolutely necessary. Ideally, they are only handled when putting them away and then again when pulling them out for use. So for this reason, all medical supplies should be packaged in Ziploc bags before storing for an extra layer of protection.
Now
if it were just about sterility and keeping the packages clean, that
would be nice. However, there are a few other factors that come into
play with medical supplies. If supplies can't be used, it doesn't
matter whether they were kept sterile. Just as with food, heat, light,
and moisture are bad for medical supplies. Keeping them all cool, dark,
and dry is the best way to extend usable shelf life.
So what influences the usability of older medical supplies? Sometimes it comes down to the individual components in those supplies.
At the beginning of covid, there was quite the little brouhaha when the government sent out face masks that were past date to health workers on the covid front line. However, even though the masks were past date, there was nothing wrong with the filter material of the mask. Rather, the concern was with the rubber or elastic holding the mask in place. If the rubber or elastic has deteriorated and doesn't hold well, a good seal can't be achieved or relied upon.
Rubber is also found a few other places in our medical supplies. Tourniquets like the SWAT-T are entirely rubber. That band is going to be under a lot of stress if it is being used, especially to stop bleeding, and shouldn't be counted on to perform too much past the date. When time is up, get a new tourniquet, and save the old SWAT-T for making a sling or holding bandages in place.
The stoppers in syringes are also made from synthetic rubber and begin to degrade within about five years. Glass syringes have a higher quality stopper that can be autoclaved repeatedly without deteriorating, so you might consider adding some of those to your supplies.
We've also discussed exam gloves in the past. Nitrile gloves have the longest shelf life--up to 5 years past date. They last much longer than latex or vinyl gloves and will resist fluids longer. However, if you are trying to prevent infection, especially from blood-borne viruses, don't push the limit too far.
Latex
tubing, like with IV bags, nasopharyngeal airways, enema bags, etc.,
lasts for 3-5 years before it starts deteriorating and needs to be
replaced.
Adhesives lose stickiness. The best quality bandages like real Band-Aids can last five or more years past date if they have been stored well. The same goes for medical tape like Transpore or even duct tape. It may not matter much if the bandage has lost a little stickiness. But if you are using a product like Steri-Strips to close a sizeable laceration, you absolutely need it to be as strong and sticky as possible. Be sure to replenish these supplies and keep fresh stock.
Clean dressings like gauze can safely be used no matter how old they are. But what if the gauze has been coated with antibacterials or impregnated with hemostats like QuikClot? It's best not to rely on those being effective. You'll want to purchase fresh QuikClot every few years as well.
The best
approach is to store your supplies like your food--clean, cool, dry, and
dark--and then to accept the fact that you'll have to spend some money
to keep fresh stock of a few items. Make it part of the annual budget.
References:
Joseph Alton, The Survival Medicine Handbook, pp 505-08.
Zachary B. Deutch, et al., "Does It Expire, or Doesn't It? Only the Manufacturer Knows for Sure," Anesthesia and Analgesia,
September 2014,
https://journals.lww.com/anesthesia-analgesia/Fulltext/2014/09000/Does_It_Expire,_or_Doesn_t_It__Only_the.36.aspx
(accessed 22 September 2020).
Gabby Landsverk, "The US Government Sent Out a Shipment of Expired Face Masks to Health Workers. Here's How Face Masks Can Expire, and When They're Still Usable," Business Insider, 18 March 2020, https://www.businessinsider.com/how-do-n95-face-masks-expire-still-work-2020-3?op=1 (accessed 22 September 2020).
Kelly M. Pyrek, "Time Versus Event: Preserving Sterile Package Integrity," Infection Control Today, 1 April 2002, https://www.infectioncontroltoday.com/view/time-versus-event-preserving-sterile-package-integrity (accessed 22 September 2020). 13 october 2020
DOD had done a big study years ago on the shelf life of standard medicine as they keep very large stockpiles. They found that most were good for decades longer. At the behest of the drug suppliers they, of course, classified that information.
ReplyDeleteYes. In the "Links to related posts" above, you'll find a link to the "Shelf Life Extension Program" which discusses this very topic.
DeleteNice job, Jennifer. I have read many thousands of preparedness articles. I remember none that covered this subject.
ReplyDeleteI really try to provide good info on essential topics that no one else addresses.
DeleteThe conditions the supplies were stored in is far more relevant than their age. And medical supplies have an expiratory date for ONE reason....lawyers. Same reason groceries have a sell by date. American hospitals throw away millions of dollars worth of perfectly good supplies because ofe an arbitrary date stamp. Some of the more enlightened ones ship the stuff to turd world countries that have need of such supplies and have few if any lawyers.
ReplyDeletePay as much attention as you would opening doubtful food when opening old medical supplies. Does it smell weird? Debris falling out? Package obviously compromised? Was it in a vehicle FAK that got set down in a puddle when rearranging the car?
ReplyDeleteDo you have any info on when test strips expire? Pregnancy tests work, with doubt, years later, do you have info on UTI strips?
ReplyDeleteUnfortunately, I didn't see anything when doing research on those strips. They aren't that expensive, so they could be replaced every year or so. Until, of course, we can't replace them. Sorry I couldn't be of more help.
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