How Bay Area hospitals are responding to national IV fluid shortage

Health care facilities in the Bay Area are changing protocols to account for the national shortage of IV fluids. 

Hurricane Helene is to blame, as the biggest supplier of fluids, Baxter, was forced to close its manufacturing site in North Carolina due to severe storm surge and flood damage.

The FDA and US Health and Human Services are suggesting hospitals cut down their use of fluids and save them for serious emergencies only.

Baxter produces about 60% of the nation's IV fluids. 

In the East Bay, Dr. Elizabeth Mahler, the Associate Chief Medical Officer for Community Hospitals with the Alameda Health System, said their hospitals primarily get their supply from Baxter. 

"They were sending out announcements that the plant was closed. The bridge is washed out so they couldn’t get supply out," said Dr. Mahler.

Like at most health care sites, the emergency, critical care, surgery, and oncology departments need the fluids most.

Wilma Chan Highland Hospital is the safety net hospital and only Level 1 Trauma hospital for the East Bay, and due to the vulnerable patient population, fluids are used often. 

"Almost all the medications we give are intravenous," said Dr. Mahler.

Doctor Mahler said the issue hit AHS hard in the first week of October, when they began getting 20% of their typical supply and were down to about a week’s worth of fluids.

"We pulled together actually an incident command center similar to what we did with COVID, in terms of making sure we had the supplies on hand," she said.

Elective surgeries were temporarily halted and protocols were changed to conserve, bringing the use of fluids down 30-40%.

"Areas where we were commonly using IV fluids that weren’t necessary, we made it easy to stop them," said Dr. Mahler.

Now, she said the shortage is impacting other hospitals as well, even the ones who don’t rely solely on Baxter for supplies, because the other suppliers are overwhelmed with requests to fill the gap. 

"Their suppliers are having to share IV fluids more broadly so everybody started, in this last week, really feeling the national shortage of IV fluids," Dr. Mahler said.

Sutter Health is also conserving supply. Its spokesperson wrote in a statement, in part, "We are planning for a prolonged shortage and are making daily decisions to optimize our current supply and increase deliveries. As a result, some non-urgent medical procedures have been rescheduled."

Kaiser Permanente said in a statement, in part, "While Kaiser Permanente uses products manufactured at this facility, we are not experiencing any impacts to care at this time. We are actively monitoring our inventories of these products and working to ensure that we can manage care delivery should there be a long-term impact from this closure. " 

The FDA has authorized health care facilities to extend the use of certain fluids past the expiration dates, but continue to encourage conservation.

Sutter Health, AHS, and Kaiser Permanente assure us patient care is not disrupted at this time.

Baxter does not have a timeline for when their facility will be fully restored, but they report a temporary bridge has already helped them push out more than 800 truckloads of product. 

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