Epinephrine Freezing?


Forum Ride Along
I run with a college rescue squad in Missouri. We currently have an SUV stocked with all BLS-level supplies, but have recently begun debating whether to have our crew chief keep the Epi-Pen with him instead of leaving it in our truck.

Will leaving the Epi-Pen in our jump bags in the truck overnight cause it to freeze or lose effectiveness? Temperatures can go well below freezing here in the winter.




Forum Deputy Chief
Read the manufactures warning, its that piece of folded up paper that comes with the drug.

It will tell you the temperatures the medication can withstand and which ones to avoid.

Buy generally yes, if it gets below freezing, and you allow your medicine to freeze. what good do you think it is going to do when you need it at 0300 on one of those frozen nights?

If you allow medication to freeze and unfreeze, freeze and unfreeze multiple times, do you think that there is a chance that the efficacy may be reduced?

If you can not answer that question, here is a simple experiment. I want you to turn down your freezer temps and allow your food to partially melt or thaw out. Then I want you to refreeze it. Do this over and over for several days.

If not impressed with the end results, then why on earth would you allow this for a medication which is to be injected in order to save a life?


Forum Asst. Chief
him the general temperature range is 15C -30C so its very small. Because there is a small shelf life and it easily oxides, I would say constant temperature fluctuation might be pretty bad for it.


Forum Captain
Isn't there a requirement in your state about keeping the rig at a certain temperature at all times? I thought it was pretty common to have such a requirement...for exactly this reason.

Even for a BLS service if it's really cold you can have issues with the truck starting (unless you guys have a block heater), irrigation saline/H20 freezing, the truck icing up, and plus, who wants to have a BP taken by a -10 degree cuff and same temperature stethoscope?

I'm not sure, but I even wonder what cold that bad does to the rubber gaskets in a BVM (stiffen beyond the point where they function?) or the flexibility of a NPA..could be alright, but I'd want to be certain.

I don't know if you guys can do BGL's, but we have a problem with ours not functioning even if left in the truck in the chilly but heated garage and then on scene for more than a minute or two...on really cold days you have to keep them on your body to keep them warm enough. Makes me wonder how cold your AED can go too.


EMS Paparazzi
Premium Member


Still crazy but elsewhere
Ther was a threasd about this a while back.

Referred to altitude then went wide.

Talwin will start condensing, beautiful clear-white crystal.

Supposed to screen Epi from light too, including fluorescent light (due to UV).

BVM's get sluggish, condensation freezes in O2 lines, gauges can stick, hard to warm up patients, locks on exterior doors can freeze, one way valves on masks and VVac suctions get hard and brittle, gloves tend to fail. Gets cold en ough, the vinyl seats crack when you hop up onto them. (Done that). Plastic buckles on kits tend to snap. Batteries can need a bit of use to get full function; if you try that with an electric motor you can burn it out, brushes arcing in one position.
Ah, here it is:

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Forum Deputy Chief
Premium Member
My college EMS also has a SUV response truck. We have a special agreement with the state (waiver) that allows us NOT to have a garage for the truck, as long as all drugs travel with the primary (indoors), and the truck is equipped with a "Winter Mode" which starts the engine and heat when the interior temperature drops below a certain temperature. That means all the fluids in the truck stay fluid (no frozen sterile water).

The idea with the meds is that they stay with a human, so if the person is cold, they should be inside.