We have received notification today that the regional IV boxes will be shorted one of the 1L NS IV bags due to this shortage.

MEMORANDUM

TO: EMS Agency Leadership

FROM: Tidewater EMS Council

DATE: 10/08/2024

SUBJECT: URGENT ADVISORY: Conservation of IV Fluid Supplies Due to Nationwide Shortage

Dear Regional Stakeholders,

Due to the extensive flood damage sustained by Baxter’s North Cove manufacturing facility in Marion, North Carolina, during Hurricane Helene, there is now a critical nationwide shortage of IV fluids. This facility produces approximately 60% of the IV fluids used across the United States, and the disruption in production is expected to have a significant impact on patient care in various healthcare settings, including EMS.

Currently, there is no estimated timeline for when production will resume to normal levels. In light of this, and with guidance from Dr. Martin, TEMS’s Regional Medical Director, we strongly urge agencies to implement IV fluid conservation strategies immediately.

Conservation Strategies:

• Conserve IV Fluids: Administer IV fluids only when necessary. Avoid “to keep open” (TKO) fluids. If the patient can tolerate oral fluids, oral rehydration is appropriate.

• No stockpiling: Please avoid hoarding or stockpiling IV fluids. Supply must remain equitable and sufficient across the region.’

• Do not pre-spike fluids: Only spike bags at the time of use to reduce waste and contamination risk.

• Maintain the outer wrap. Do not remove the outer wrap of IV fluids until they are ready to be used, to maintain sterility and increase shelf life.

• Consider preserving unspiked IV products: If IV fluids have been brought to the patient and unwrapped but not spiked, consider not disposing of them to avoid unnecessary waste.

• Accurate hand-off documentation: Ensure that EMS personnel communicate the exact amount of IV fluids administered during hand-off to hospital staff, particularly for patients with conditions such as sepsis, suspected diabetic ketoacidosis (DKA), or any situation requiring fluid resuscitation. This will assist hospitals in inaccurate fluid management.

• Monitor FDA guidance on expiration dates: Pay special attention to any guidance from the FDA regarding IV fluids, as expiration dates may be extended beyond those printed on the packaging during the shortage.

• If conservation measures could negatively affect patient care, the patient's needs should always take precedence, and IV fluids should be used as clinically indicated.

The American Hospital Association and federal agencies are working closely with Baxter and other manufacturers to address the shortage, but it is likely to persist for weeks or even months. It is crucial to proactively manage your inventory and implement patient care strategies to help mitigate the impact.

We will continue to monitor the situation and will provide updates as more information becomes available. If you have any questions or need further assistance, please feel free to contact our office.

Thank you for your cooperation and continued dedication to patient care during this challenging time.

Thank you,

Dave

Learn your trade, before you learn the tricks of the trade.