The shortage of intravenous fluids, as a result of the damage caused by Hurricane Helene, is forcing some hospitals in the United States to postpone elective surgeries and other non-urgent procedures in order to preserve existing fluids.
The catastrophic flooding caused by Helene affected facilities of Baxter International, the largest manufacturer of intravenous fluids in the country, in North Carolina, causing its temporary closure and reducing shipments to hospitals.
In addition to this, B. Braun Medical, the second largest manufacturer of intravenous fluids in the country, announced on Tuesday the temporary closure of two of its facilities in Daytona Beach, Florida, due to the arrival of Hurricane Milton.
The Minnesota Hospital Association, which represents more than 140 hospitals and health systems across the state, has held daily calls since last week with hundreds of medical providers who have expressed concern about the limited supply of serum and deadline for Baxter’s North Carolina facility to return to operation, according to a spokesperson.
UVA Health University Medical Center in Charlottesville, Virginia, postponed some surgeries this Wednesday, Thursday and Friday to help conserve its supply of intravenous fluids, according to spokesman Eric Swensen.
Some elective surgeries at UVA Health hospitals in Culpeper, Haymarket and Manassas as well were being rescheduledSwensen explained, adding that they will review their calendars daily to determine which operations need to be postponed.
He also indicated that the medical center has “redoubled” efforts to avoid the waste of intravenous fluids, since it is the only level 1 trauma hospital in the area.
How hospitals are preserving serums
Baxter represents about 60% of the intravenous IV market in the United States and most hospitals in the country rely on its products, which are used to deliver drugs or electrolyte water directly into the patient’s bloodstream.
Intravenous fluids are essential during surgery because they keep patients hydrated, help regulate blood pressure and compensate for the loss of fluids, such as blood. Switching suppliers can be challenging for hospitals, as contracts require them to maintain relationships with manufacturers for years.
To preserve supply, some hospitals are beginning to reschedule non-urgent operations, such as the removal of tumors that do not require immediate treatment or cardiac ablation procedures for people with arrhythmias, according to the Minnesota Hospital Association spokesperson.
A “gray market” is also starting to emerge, with people posting on Facebook that they have IV bags for sale, even though hospitals don’t buy them, the spokesperson explained. “It’s the Wild West.”
Minneapolis-based Hennepin Healthcare has had to cancel or reschedule some surgical procedures, said Christine Hill, a spokeswoman. He specified that patients are being notified.
“We are also in contact with other health systems to coordinate efforts and resources as needed during this difficult time,” he said.
No new shortages have been declared
On Monday, the American Hospital Association, which represents 5,000 hospital centers and health systems, sent a letter urging President Joe Biden to declare a national emergency over the limited supply of intravenous fluids.
Various intravenous products, such as sodium chloride, dextrose and sterile water have already been in short supply. The closure of the Baxter facility has not yet caused any new shortages of intravenous fluids, the Food and Drug Administration (FDA) reported Tuesday.
This Wednesday, the Department of Health and Human Services (HHS) reported that the closure “will likely lead to new restrictions.” In the meantime, he said, the FDA has allowed the use of compounded versions of the products in shortage.
Baxter is working with the Administration for Strategic Preparedness and Response (ASPR), an HHS agency, to get its North Carolina factory back online.
Flooding from Hurricane Helene damaged bridges leading to the facility, but efforts to fix the plant appear to be making progress.
In an update posted on its website Wednesday, Baxter said it aims to return to “90% to 100%” of “certain intravenous solutions” products by the end of the year. He also said that as of this Wednesday, he is increasing the delivery of his most in-demand IV fluids to direct customers from 40% to 60% and increasing the delivery to distributors from 10% to 60%.
“Our goal remains restore 100% delivery levels to customers as soon as possible“declared the company.
It is unclear whether the end of the brief port strike on the East and Gulf coasts of Mexico last week – which prevented the movement of goods to the continental United States – has helped the supply. Baxter has other facilities, including in Puerto Rico. The company did not respond to a request for additional comment.
In its statement Wednesday, the company said its assessment of the offer is based in part on “the anticipated timing of incoming products and shipments,” suggesting it is bringing in products from other facilities.
Zachary Dembner, a spokesman for ASPR, said the agency is encouraging manufacturers and distributors to evaluate their supplies and asking healthcare providers to implement conservation strategies to preserve the serums they have in stock.
On Tuesday, the agency also helped safely move intravenous products from the B. Braun Medical facility in Daytona Beach. away from the path of Hurricane MiltonDembner said.
Those facilities – which were working with ASPR on the supply – closed Wednesday morning and are expected to resume normal operations on Friday, B. Braun Medical spokesperson Alli Longenhagen said in a statement.
Delay in medical services
Hospitals are closely monitoring the situation.
A spokesperson for Enloe Health, a medical center in Chico, California, said it is closely monitoring its inventory of intravenous IVs to ensure it has enough for patients who need them. The center is also looking for alternative suppliers.
Enloe Health had suspended elective surgeries. The spokesperson noted that since then they have resumed “within certain clinical parameters”.
Shea Siegert, spokesperson for the Alaska Native Tribal Health Consortium (ANTHC), reported that no operations were being postponed, but that providers were taking steps to preserve supply.
“ANTHC is proactively pursuing conservation strategies to ensure availability (of sera) across the state for the duration of the anticipated shortage,” Siegert said.
