Impact of current fluid deficiency IV

Intravenous (IV) fluids are an important a part of the healthcare system; Hospitals cannot function without them. Insufficient supplies of those life-saving solutions should not an anomaly. In June 2018 US Food and Drug Administration (FDA) announced a shortage of 9% sodium chloride IV, or saline solution (NSS), after Hurricane Maria. Since then, sterile water for injection has been briefly supply as of November 2021, while supplies of 5% dextrose IV and 10% dextrose IV remain insufficient as of February 2022 (FDA, n.d.). The causes of those shortages are multifactorial and include limited quantities worldwide, increased demand and production issues.

Category 4 Hurricane Helene made landfall in Florida late last month, devastating communities in its path. It curved inward, crossed Georgia, was downgraded to a Category 2 and caused significant flooding in North Carolina, destroying Baxter International’s North Cove manufacturing plant. Baxter is the biggest supplier of intravenous fluids and dialysis solutions, producing 60% of intravenous solution supplies to U.S. hospitals (FDA, n.d.). This storm has added to the strain on an already stressed system, as Baxter must now limit the quantity of intravenous fluids the ability can order.

On October 12, 2024 at Centers for Disease Control and Prevention (CDC) issued an alert to tell all health care providers, pharmacists, facility administrators and state health departments of the disruption in the provision of peritoneal dialysis and intravenous (IV) solutions from Baxter’s facility in North Carolina. The CDC warned that stock reductions could “impact patient care and require adjustments in the clinical management of patients.” Days later, the U.S. Department of Health and Human Services (HHS) invoked the Defense Production Act to assist rebuild the Baxter plant. While other manufacturers have increased production and intravenous fluids are being imported from other countries, healthcare facilities should exercise caution. Secretary Becerra of HHS encourages clinicians to “implement product maintenance strategies to maintain safe and high-quality patient care and maximize available supply” (HHS, 2024).

Health care institutions across the country are feeling the squeeze. Clinical nurse specialist Kerry Corcoran, who works within the Bay Area, was notified by her administration a couple of shortage of intravenous fluids. “Our facility defers non-urgent and non-urgent elective surgical procedures if they require two or more liters of fluid,” Corcoran said. She was told that shortages are expected through the top of 2024. In Colorado, Dr. David Schnur of Banner Health/MD Anderson adds, “We are currently deferring elective cases requiring high-volume hydration.”

These measures are consistent with the most recent CDC (2024) recommendations for healthcare providers, pharmacists, and facility administrators, which include:

• Assess inventory and determine whether a shortage will impact the ability.
• Monitor current and future solution deliveries IV.
• Keep IV solutions available.
• Implement facility-specific motion plans to optimize using IV solutions corresponding to:
  • Assess protocols and the clinical must proceed intravenous fluid substitute at each shift change, bag change, and through transitions of care unless clinically vital.
  • Use oral preparations when intravenous options should not available, when appropriate and secure.
  • Identify secure and effective alternative IV options (e.g., nearby facilities)

Has the recent shortage of intravenous fluids impacted your facility? Let us know within the comments below.

Centers for Disease Control and Prevention (2024, October 12). Disruptions in the provision of peritoneal dialysis and intravenous solutions on the Baxter International facility in North Carolina. Downloaded from https://emergency.cdc.gov/han/2024/han00518.asp

U.S. Department of Health and Human Services. (2024, October 9). Letter to Health Care Leaders and Stakeholders on the Impact of Hurricane Helene from Secretary Becerra. Downloaded from https://www.hhs.gov/about/news/2024/10/09/letter-health-care-leaders-stakeholders-impacts-hurricane-helene-secretary-becerra.html

U.S. Food and Drug Administration (n.d.). Hurricane Helene: Baxter Manufacturing Revival in North Carolina. Retrieved October 16, 2024 from https://www.fda.gov/drugs/updates-2024-hurricane-season/hurricane-helene-baxters-manufacturing-recovery-north-carolina