It just doesn’t seem right that the national crisis with “drug shortages” would include  large volume (1000mL) IV solutions we commonly administer to our patients:

• 0.9% Sodium Chloride Injection
• 0.45% Sodium Chloride Injection
• Lactated Ringer’s Injection
• 5% Dextrose Injection

But the reality is there is a shortage, IV saline solution, in particular is on the list of national drug shortages and the shortage is not expected to resolve until May or June this year. Not having IV Saline solution available  is like not have bread and milk at the grocery stores.

So what can be done?  The American Society of Health-System Pharmacists (ASHP) released a list of conservation strategies that organizations might consider to manage the shortage.  Click here to view details of the document.

What can clinicians do to conserve?

• Use oral hydration whenever possible.
• Review the suggested clinical approaches and product conservation strategies in collaboration with the organization’s stakeholders and the Pharmacy and Therapeutics (P&T) Committee or other organization-wide medication policy group for applicability to the organization.
• Implement an organization-specific action plan to conserve IV fluids where possible. Allow flexibility as the shortage status of specific products may change frequently. For example, Lactated Ringer’s
• Injection may be more available than 0.9% Sodium Chloride Injection and vice-versa depending product availability and allocation schedules.
• Develop medical staff-approved policies for substitution of IV solutions based on product availability within the organization. Example: an organization might allow substitution of Lactated Ringer’s Injection for 0.9% Sodium Chloride Injection or vice-versa depending on what is in stock. Table 1 provides a comparison of common intravenous fluid components.

 

Please feel free to share what you /your organization are doing to cope with this IV Solution Shortage.