When do medical supplies expire?
August 12, 2020
Turning on the expiring items notifications in Inventory Wolf, and setting the Expires field for items with expiration dates is a great way to keep abreast of your disaster preparedness supplies’ health – but when do medical supplies really expire? And can you still use them when they do expire?
Ultimately you want medical items to expire, unused. That chest seal for treating sucking chest wounds expire? Thank heavens! But you still want to be aware of how long after the expiry date the item can still be used, and how expiry changes the item. We’ll explore that here with regards to the items recommended in Inventory Wolf’s first-aid kits.
For the purposes of this article, we’ll assume un-opened items that have been stored in a cool, dry, dark place, which is where you should be storing your medical supplies.
- The expiry dates of opened items such as creams, gels, and liquids should be heeded. Once you unseal an item, it will begin to degrade at a faster rate, and anywhere you have high moisture content, as with creams, you have a greater opportunity for bacteria to grow. Eventually the preservatives lose effectiveness, and then the bacteria can proliferate.
- In general, assume that medications, antiseptics, antibiotics, sunscreens, etc, become less effective after their expiry date as their active ingredients degrade or evaporate. Before you keep, or use, any such expired item, consider the worst thing that could happen if the drug doesn’t work. For example, if you’re spending long days outside in the sun using long-expired sunscreen, you could be setting yourself up for skin issues.
- Tourniquets – SWAT-T tourniquets are essentially large rubber bands, and rubber degrades over time, so heed their expiration dates. Nylon strap type tourniquets don’t really have anything that is going to degrade in an appreciable time frame, unless they’re stored in a harsh environment.
- Irrigation syringes – The stoppers for syringes are typically made of synthetic butyl rubber. Once the stopper degrades, it can start disintegrating and reduce irrigation water pressure, or result in bits of rubber being squirted into the wound. With the help of MIL-HDBK-695D Military Standardization Handbook Rubber Products: Recommended Shelf Life, we see that synthetic butyl rubber has a shelf-life of 5-10 years.
- Nitrile gloves – Typically have a shelf life of five years before they are no longer guaranteed to be fluid-resistant. If you are using these gloves to avoid blood-born viruses, you’ll want them to not be expired.
- Nasopharyngeal airways, with lube – These are essentially soft latex tubes, and so have a shelf-life of 3-5 years (per MIL-HDBK-695D). Make sure that if you keep a packet of lube with them, that they have compatible expiry dates.
- Shears, Tweezers, Safety pins, Aluminum splints, Mylar blankets – Don’t expire.
Bandages and Dressings
Bandages hold dressings onto the wound.
Modern elastic bandages are typically constructed from cotton, polyester, and latex-free elastic yarns, which don’t degrade in any appreciable time. Adhesive bandages, however, will lose stickiness over time, but quality adhesive bandages will retain their stickiness for at least 5-10 years.
Quality medical tape, moleskin, and chest seals, also fall under the 5-10 year stickiness retention guideline. For suture strips, however, you should heed the package expiration date, since you’ll want maximal stickiness when holding those larger gashes together.
Dressings are a different matter since they range from a simple sterile gauze, to hemostatic-impregnated, or even with anti-bacterial creme, etc. For simple sterile gauze, the expiration date on the packages typically indicates until when sterility is guaranteed, to help prevent infection from pathogens present within the dressing. There have been studies that show no significant difference in wound infection rates between sterile and clean dressings (1, 2, 3), so you could consider dry dressings such as gauze, as having no expiration date.
For dressings with active ingredients such as QuickClot, you’ll want to heed the manufacturer’s expiration dates, as their effectiveness will surely degrade over time. Don’t throw them out (see below), but do freshen up your stock.
Again, assume that medications, antiseptics, antibiotics, sunscreens, etc, become less effective after their expiry date as their active ingredients degrade or evaporate. Some notables and exceptions:
- Acetaminophen – A Stability of Active Ingredients in Long-Expired Prescription Medications study found acetaminophen (ie, Tylenol) to be stable for 20+ years.
- Diphenhydramine – The Shelf Life Extension Program (SLEP) found diphenhydramine (a common antihistamine) to be stable for 15+ years.
- Doxycycline – Stick to the label expiration even though the FDA is allowing the use of certain lots of doxycycline (a broad-spectrum tetracycline-class antibiotic) beyond the expiration date.
- Aspirin – Heed the label expiration. If moisture has gotten into the bottle some of the aspirin (acetylsalicylic acid) will react with water to give back salicylic acid and acetic acid (vinegar). The Stability of Active Ingredients in Long-Expired Prescription Medications study showed aspirin present at < 1% of the stated amount in the old drugs.
- Potassium iodide – Stockpiled in the US for a radiation emergency, potassium iodide tablets are inherently stable and do not lose their effectiveness over time, per FDA.
What to Do With Expired Items
Rotate expired medical supplies to the back shelf if there’s room. Even though they may be less effective, they can be better than nothing, in case nothing else is available. On a more cynical note, you could use them as bait, or as part of a “tribute” should you get squeezed, and need to buy some time…
Related Fun Facts
- Bleach has a 6 month expiration date, at which point it begins to break down into salt and water
- Hand-warmers last around five years
- Kevlar has an expiration date, heed the label
- Ballistic plates expire, heed the label