Eastern Iowa healthcare facilities recovering from IV shortage

Feb. 03--Although the nationwide shortage of intravenous fluids is expected to improve soon, local hospitals remain cautious as the number of people suffering from the flu could continue to rise this season.

Since Hurricane Maria knocked out key medical supply manufacturers in Puerto Rico in September, hospitals across the United States have been experiencing a shortage of intravenous fluids. These IV fluids, packaged in clear plastic bags and tubes, are used to deliver fluids and medications to patients intravenously.

Three factories operated by Baxter International in Puerto Rico lost power because of the storm, causing them to shut down for several days, according to national reports.

The U.S. Food and Drug Administration said last month it expects the shortage of IV bags to improve in the near future, but hospitals experienced a tough past few months juggling patient care with essential supply shortages.

Some hospitals, including Mercy Medical Center in Cedar Rapids, saw an impact as early as late October, said Jamie Sinclair, director of pharmacy services.

"We appear to be coming out of the shortage, but what is more unclear is how long that full recovery will take," Sinclair said.

Officials a the University of Iowa Hospitals and Clinics noted they saw the most significant effect on their supplies of 50mL and 100mL bags of saline and dextrose -- mixtures that are used to deliver fluids and medicine to hospital patients through IV bags.

As a result, nurses and physicians turned to other sizes of the bags and to other fluids, which eventually caused shortages in those solutions as well.

"We are feeling the strain on resources, but we never at any time had complications that would compromise our patient care," said Terry Best, materials management manager for Mercy Iowa City.

UnityPoint Health, the statewide network, has been closely monitoring the supply of some pharmaceutical products, the network told The Gazette in a statement Friday.

"We are working to minimize impact to patient care and services at UnityPoint Health-St. Luke's Hospital at this time, by implementing system and industry strategies and best practices," the statement said. "We are also actively working to ensure our federal and state governments understand the severity of this situation and the potential impact our patients."

Some hospitals, such as Mercy Medical Center in Cedar Rapids, implemented conservative strategies early on to stay ahead of the shortage. Sinclair said the hospital implemented strategies in early November, asking providers to use alternative methods such as a syringe to deliver medication.

Mike Brownlee, UIHC's chief pharmacy officer, said the hospitals saw the most intense shortages through November and December and had to be resourceful to meet the need.

"Here at UI Health Care, we are fortunate to have facilities that allow us to take the raw materials for making both of these solutions," Brownlee said. "We combined those together -- sterile water plus dextrose -- and we would actually make the right concentration of fluid.

"There was a period of time we were having to do that on a regular basis because we just couldn't buy enough of the fluids that we needed," he said.

But with this year's flu season -- which has resulted in 77 flu-related deaths throughout the state, according to the most recent Iowa Department of Public Health report -- has hit area hospitals hard with an influx of patients to emergency departments and outpatient clinics.

"We have seen our inventory decrease a little bit because of the flu, but we're still holding steady and we have not had to turn any patients away," Brownlee said.

National and state health officials have emphasized the severity of this year's flu season, and it's only expected to get worse. The Centers for Disease Control and Prevention reported Friday 16 children died this week as a result of the flu, bringing the nationwide total to 53.

The CDC does not track flu-related deaths in adults.

UIHC was among area hospitals that implemented patient-visit restrictions due to influenza, and officials there are expecting the high rate flu-related patient visits to continue.

Brownlee said he believes they have enough IV fluids stock right now to get through the peak of the flu season. That is expected to hit sometime during the beginning of this month state health officials have said.

Other area hospitals remain cautiously optimistic their supply of saline, dextrose and other IV fluids will return soon, and will not be hugely impacted by this year's flu season.

"I feel confident if we see an increase in flu-related hospitalizations, there will not be any negative impact on patient care," Sinclair said.

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