Could hurricanes be to blame for an IV bags and solutions shortage?
They are bedside companions for thousands of hospital patients across the country.
Those intravenous or IV bags, that hang from a hook, are a vital medical tool containing supplies of saline and nutrient solutions.
“Thousands in a month,” says INOVA Hospitals Pharmacy Manager Arpit Meht. “Every patient that comes into the hospital is on some sort of an IV fluid, whether it be hydration or medication therapy.”
But just as flu season is kicking into high gear, many hospitals in the DMV are scrambling to find adequate supplies of IV bags and fluid.
The shortage, triggered by a hurricane 1,500 miles away.
“I would say we are in a crisis right now,” says Deborah Pasko, with the American Society of Health System Pharmacists, or ASHP, for short. “There are many organizations that are running extremely low, if not completely out of IV solutions at this time.”
When Hurricane Maria slammed into Puerto Rico, it also knocked out electricity for the entire island.
Among the businesses affected were three manufacturing plants operated by Baxter International, which makes—you guessed it—IV bags and solutions.
“Our thought was how are we going to take care of our patients in the community,” Meht says. “So we focus primarily on what we have on hand and how do we conserve.”
There are no exact numbers, but published reports say Baxter makes tens of millions of IV bags every year about 43 percent of the supply for the entire US.
The Washington Post says Baxter was back on line just before Christmas.
The company’s plants, now powered by generators.
But the supply is intermittent, and Baxter is now dealing with a two-month backlog.
The American Hospital Association says the resulting shortage is “quickly becoming a crisis, and a threat to public health.”
“So we started working proactively as soon as we learned about the shortages,” Meht says.
INOVA’s five hospitals launched a conservation strategy, that included inspecting its IV stockpile, and carefully monitoring their use during surgeries.
Hospital staffers are now doing workarounds that include the use of oral medications and syringes to inject fluids, instead of IV drips.
Medical teams are also trying to time out the use of IV drips, taking patients off the bags as soon as safely possible, all while keeping within safety protocols.
“We use oral medications when possible, when it's clinically appropriate for our patients,” Meht says.
Supplies of the IV products have been periodically low since 2014, and plants like Baxter’s generally shut down for maintenance at the end of the year.
Some hospitals are taking unusual steps to continue proper medical care.
At Massachusetts General Hospital in Boston, nurses are using Gatorade to help patients combat dehydration.
A hospice facility in Palm Beach, Florida has ordered 17 cases of IV bags from an FDA-approved British supplier.
“Gatorade is an option,” says one health-care giver there. “Coconut water is an option. If a person can swallow, that’s a way to keep somebody hydrated.”
The timing of the shortage couldn’t be worse, experts say.
“The timing is really awful, because as you see, we’re already at a shortage with IV solutions,” Pasko says.
Authorities say Baxter is hoping to get back to full manufacturing mode by sometime in February.
Still, the wait presents a big challenge for healthcare facilities, dependent on the bedside containers.
Pasko says ASHP is in talks with members of Congress, to discuss more transparency from IV suppliers, including where their facilities are located—and if they have emergency plans in case of a disaster.
“…For those critical items that we really must have,” she says. “Contingency plans from those companies, so when we do get into a crisis, that we have a backup system for them.”