Hospitals around the country are conserving critical intravenous fluid supplies to cope with a shortage that may last months. Some hospital administrators say they are changing how they think about IV fluid hydration altogether.<\/p>\n
Hurricane Helene, which hit North Carolina in September, wrecked a Baxter International facility that produces 60%<\/a> of the IV fluids used in the U.S., according to the American Hospital Association.<\/p>\n The company was forced to stop production and is rationing its products. In an update posted Nov. 7<\/a>, Baxter said its North Cove facility had resumed producing some IV fluids. In an email to KFF Health News, the company wrote that customers will be able to order normal quantities of \u201ccertain IV solutions products\u201d by the end of the year, but there is no timeline for when the North Cove facility will be back to prehurricane production levels.<\/p>\n Meanwhile, hospitals are facing seasonal strains on their already limited IV fluid resources, said Sam Elgawly, chief of resource stewardship at Inova<\/a>, a health system in the Washington, D.C., area.<\/p>\n \u201cWe\u2019ve been very aggressive in our conservation measures,\u201d Elgawly said, stressing that he does not believe patient care has been compromised. He told KFF Health News that across the system IV fluid usage has dropped 55% since early October.<\/p>\n Elgawly called the shortage a crisis that he expects to have to continue managing for some time. \u201cWe are going to operate under the assumption that this is going to be the way it is through the end of 2024 and have adopted our demand\/conservation measures accordingly,\u201d he said.<\/p>\n At the end of the calendar year, many patients with insurance hurry to schedule surgical procedures before their deductibles reset in January. Elgawly is eyeing that typical surgical rush and the impending peak of respiratory virus season as he tries to stockpile IV fluid bags. Hospitals such as Inova\u2019s are using different ways to conserve, such as giving some medications intravenously, but without a dedicated IV fluid bag, known as a push medication.<\/p>\n \u201cYou don\u2019t even need a bag at all. You just give the medication without the bag,\u201d he said. \u201cThere has been increasing literature over the last 10 to 20 years that indicates maybe you don\u2019t need to use as much. And this accelerated our sort of innovation and testing of that idea.\u201d<\/p>\n Monica Coleman is a nurse at a Department of Veterans Affairs hospital<\/a> in North Chicago. She said using push medications takes more time out of a nurse\u2019s already hectic schedule because then they need to monitor the patient.<\/p>\n \u201cThis could increase adverse effects within the patient, because we\u2019re giving the medication at a faster rate,\u201d she said.<\/p>\n Elgawly is also interested in retooling electronic health records to question doctor orders for more IV hydration.<\/p>\n \u201cDoes the patient actually need that second bag? How did they do today with eating or drinking water or juice? They did well? They don\u2019t need the bag. So it\u2019s little conservation mechanisms like that that, when you add them across, you know, the 2,000-patient system that Inova is, make a significant dent,\u201d he said.<\/p>\n Simpler conservation measures could become common after the shortage abates, said Vince Green<\/a>, chief medical officer for Pipeline Health, a small hospital system in the Los Angeles area that serves mainly people on Medicare and Medicaid.<\/p>\n First, Green would like to see data showing that patient outcomes aren\u2019t affected. But for now, some of the new strategies just make sense to him. He has directed hospital staff to use up the entire IV bag before starting another.<\/p>\n \u201cIf they come in with IV fluids that the paramedics have started, let\u2019s continue it. If it saves half a bag of fluids, so be it, but it adds up over time,\u201d he said.<\/p>\n Patients may be asked to take more accountability for their hydration, by drinking Gatorade or water rather than the default of hydrating through an IV, he said.<\/p>\n \u201cFrom an environmental aspect, we don\u2019t need to have this much waste and fill up our landfills. If we could reduce stuff, I think it\u2019d be wise,\u201d he said.<\/p>\n But he\u2019ll feel better when his hospitals receive a full order, which could be weeks away. Green said they are down to a two-week supply, with an expected increase in hospitalizations due to respiratory virus season.<\/p>\n \u201cWe\u2019re purchasing every IV fluid bag that we can get,\u201d he said.<\/p>\n\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\nUSE OUR CONTENT<\/h3>\n