NursingCenter Blog

Impact of the Current IV Fluid Shortage

Oct 18 2024 by Myrna Buiser Schnur, MSN, RN

Intravenous (IV) fluids are an indispensable staple in the healthcare delivery system; hospitals cannot function without them. Insufficient reserves of these life-saving solutions are not an anomaly. In June 2018, the U.S. Food and Drug Administration (FDA) announced a shortage of sodium chloride 9% IV, or normal saline solution (NSS), following Hurricane Maria. Since then, sterile water for injection has been in short supply as of November 2021 while the stockpile of dextrose 5% IV solution and dextrose 10% IV solution remains deficient as of February 2022 (FDA, n.d.). The causes of these shortages are multifactorial, including worldwide limited quantities, increased demand, and issues in production.

Late last month, Category 4 Hurricane Helene made landfall in Florida, devastating communities in its path. It curved inward, traveled through Georgia, was downgraded to a Category 2, and caused significant flooding in North Carolina, damaging Baxter International’s North Cove manufacturing plant. Baxter is the largest source of IV fluids and dialysis solutions, producing 60% of the IV solution supply for hospitals in the U.S. (FDA, n.d). This storm worsened the burden on an already strained system, as Baxter must now restrict the amount of IV fluids a facility can order.

On October 12, 2024, the Centers for Disease Control and Prevention (CDC) issued an alert to inform all healthcare providers, pharmacists, facility administrators, and state health departments of a supply disruption of peritoneal dialysis and intravenous (IV) solutions from Baxter’s facility in North Carolina. The CDC warned that this inventory reduction could “impact patient care and require adjustments to the clinical management of patients.” A few days later, the U.S. Department of Health and Human Services (HHS) invoked the Defense Production Act to assist in the rebuilding of Baxter’s factory. While other manufacturers have ramped up production and IV fluids are being imported from other countries, healthcare facilities should remain cautious. Secretary Becerra of the HHS encourages clinicians to “implement product conservation strategies to maintain safe, quality patient care and maximize available supply” (HHS, 2024).

Healthcare institutions around the country are feeling the squeeze. Clinical Nurse Specialist Kerry Corcoran, who works in the Bay Area, was notified by her administration of the IV fluid shortage. “Our facility is postponing non-emergent and non-urgent scheduled surgical procedures if they require two or more liters of fluid,” Corcoran stated. She was informed that the shortages are expected through the end of 2024. In Colorado, Dr. David Schnur, with Banner Health/MD Anderson, adds “We are currently postponing elective cases requiring high-volume irrigation.”

These measures align with recent recommendations from the CDC (2024) for healthcare providers, pharmacists, and facility administrators, which include the following:

Assess inventory and determine if the shortage will impact the facility.
Monitor current and future supplies of IV solutions.
Conserve available IV solutions.
Implement facility-specific action plans to optimize the use of IV solutions such as:
- Evaluate protocols and the clinical need to continue IV fluid replacement at every shift change, bag change, and during the transition of care unless clinically necessary.
- Use oral formulations when IV options are not available, when appropriate and safe.
- Identify safe and effective alternate IV options (e.g., nearby facilities)

Has the recent IV fluid shortage impacted your facility? Let us know in the comments below.