IV fluid shortage forces Missouri hospitals to conserve, delay surgeries
ST. LOUIS Hospital systems in the St. Louis area are taking measures to conserve intravenous fluids after hurricane damage caused a nationwide shortage, while other hospitals across Missouri are also having to postpone some elective procedures.
About 60% of the nation's IV supplies relied on production from Baxter, a medical supplier in western North Carolina that was damaged by Hurricane Helene last month.
IV fluids are sterile fluids that are injected into a vein to treat dehydration, provide nutrients, deliver medications, or replenish fluids lost from an illness or injury. They are typically plentiful in medical settings including outpatient and imaging centers.
"My whole last two weeks have been trying to figure out how to alleviate any concerns," said Joseph Buchanan, pharmacy director for SSM Health St. Joseph Hospital-St. Charles and co-leader of the drug shortage committee for the entire SSM Health system. "Fluids are everywhere. IV fluids are a big part of all health care, especially with the most critical patients that are coming to the hospitals."
Buchanan said his hospital alone gets two truckloads of IV fluids a day. Thankfully, he said, Baxter is not the main supplier for SSM Health, but all the suppliers are now strained as they try to fill the gap.
Officials with SSM Health and other health systems in the St. Louis area — Mercy, BJC HealthCare and St. Luke's Hospital — say they are diligently monitoring their amounts and have been able to rely on conservation strategies instead of surgery cancellations, for now.
"We are conserving where appropriate and taking other measures to make the best use of the IV supplies we have and continue to receive," read a statement released by Mercy officials. "If we need to make any changes to future patient care, we will work directly with patients on planning their care."
These management efforts include using oral hydration with fluids such as Gatorade and Pedialyte whenever possible, treating patients with the smallest amount possible, administering medications with a syringe of fluids instead of intravenously.
"Mainly just being more diligent," Buchanan said, which requires close coordination with providers such as nutritionists and surgeons to determine how to safely conserve the fluids.
"Communication is key — making sure you are getting the right people in the room to have a conversation about what is best for the whole system," he said.
President Joe Biden's administration has invoked the wartime powers of the Defense Production Act to speed rebuilding of the Baxter factory, pushing Baxter to the front of the line for construction needs. The U.S. Food and Drug Administration has allowed temporary shipments of IV fluids from other countries.
Still, a shortage is expected to last until the end of the year, when the Baxter plant is expected to be fully operational.
Several hospitals across the country report having to postpone some nonurgent surgeries, including University of Missouri Health Care and Boone Health in Columbia, Mo., which serve many rural residents.
Eric Maze, spokesman for MU Health Care, said the hospital has implemented a system to determine when its providers must delay some elective procedures based on the number of days of IV fluid supply on hand, which fluctuates daily.
Last Friday, the hospital had to postpone about a dozen elective surgeries requiring large amounts of IV fluids for later this month, Maze said.
"Since Friday, we have not had to reschedule any cases thanks to our conservation efforts," he said.
The Missouri Hospital Association has some insight into how its hospitals are faring through the state's emergency response communications network, said Dave Dillon, spokesman for MHA.
Conservation strategies have ensured that hospitals have enough IV fluid supply for emergency cases and patients needing life-saving medications and therapies, Dillon said.
"Virtually every hospital is affected in some way," he said. "Depending on the level they are affected, they are looking at the way they are delivering care including ... using it more efficiently, or pausing some sorts of care so they are conserving that resource."
It's unknown how many, Dillon said, but some providers have had to postpone surgeries or may have to in the near future if supplies are not replenished quick enough.
"There may be some rescheduling, just to be able to manage through both the supply as it exists, and then to figure out as we move forward with reduced capacity for production," he said.
Buchanan, with SSM Health, said that going through the COVID-19 pandemic left health systems better able to respond to shortages such as this one.
"It helped us learn how to think differently and react quicker," Buchanan said. "It helped supply chains understand how to get stuff to the neediest places quickly and assess what is truly needed."
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