IV FLUID SHORTAGE
What to KNOW , DO & SHARE
Tuesday , Oct . 15 – Update for Med Staff
KNOW : Healthcare facilities across the country are implementing conservation plans and warning the public of potential disruptions in elective surgical procedures since Baxter International temporarily closed an IV fluid manufacturing site in Marion , North Carolina . The Marion factory supplied 60 % of the nation ' s IV fluids to health facilities .
Renown is actively implementing measures to conserve its supply of IV fluids , an essential component in patient care across multiple departments .
DO : You can help conserve IV fluids by implementing the following techniques . Adult IV Fluid Conservation Tactics :
• Need for IV fluids addressed in rounds as well as transitioning meds to oral or IV push
• Hang time of IVF maintenance increased to 96 hours
• IV piggyback hung as primary if patient does not have maintenance fluid ordered
• Utilizing smaller NS bags for blood transfusions
• Limit TKO lines and saline lock IVs when possible
• Finish IV fluids running during transitions , example ER to floor
• DKA order sets in process of being updated to reduce D5 1 / 2NS step
• Transition from sterile water to tap water for all enteral tube med administrations as well as free water flushes
• TKO lines should only be utilized if patient is receiving more than 4 IV piggybacks in 24 hours .
• Dialysis patients : utilization of 1L NS bags instead of 2L NS bags and if patient needs additional fluid , 500ml or 250ml NS will be used .
• For patients receiving medications via NGT / PEG tube , medications will be crushed and mixed with tap water instead of sterile water .
Labor & Deliver IV Fluid Conservation Tactics :
• Decrease mainline IV fluid in our vaginal delivery order set from 125 / hr to 50 / hr
• Give every patient ONE bag of Pitocin as a bolus and then assess for bleeding and fundal massage
• If patient is low risk in epic scoring and bleeding is light / scant and fundus is firm we will discontinue line
• If bleeding is moderate / heavy and / or fundus is boggy we will give second bag as we standardly do
• A second bag automatically for anyone moderate / high risk in epic scoring
Surgical Services Conservation Tactics :
• Cease use of devices that require IV / irrigation solutions where an alternative technique is available ( i . e Aquamantys , Coblator devices )
• Avoid using or consider alternative methods of mixing antibiotic wound irrigation that avoids the use of bagged IV fluids such as using bottled irrigation and basin / bulb syringe