Severe IV fluid shortage

[jon-nyc]

Due to an NC plant closure caused by Helene.

https://www.beckershospitalreview.com/supply-chain/mass-general-brigham-reports-iv-fluid-shortage.html?utm_source=atssocialmedia&utm_medium=x&utm_content=100524x_01link

[Jolly]

It's not rocket surgery to make most of that. FDA waiver for somebody?

[Mik]

You're really talking about saline solution, right?

[Jolly]

I suspect Ringer's, D5, Normal Saline, etc.

[jon-nyc]

Good news and bad news:

U.S. officials approved airlifts of IV fluids from overseas manufacturing plants on Wednesday to ease shortages caused by Hurricane Helene that have forced hospitals to begin postponing surgeries as a way to ration supplies for the most fragile patients.

The current shortage occurred when flooding coursed through western North Carolina and damaged a Baxter plant, which is now closed for cleaning.

But…

The situation could become even more dire now that Hurricane Milton is hitting Florida. On Tuesday, workers at B. Braun, makers of a fourth of the nation’s IV fluids, loaded trucks at the company’s plant in Daytona Beach with the medical bags and drove them north through the night to what they hoped would be a safer location.

The Baxter plant, in Marion, N.C., and the B. Braun site in Daytona Beach manufacture about 85 percent of the nation’s supply of IV fluids.

[Axtremus]

@Mik said in Severe IV fluid shortage:

You're really talking about saline solution, right?

I suppose the challenge is packaging.

[Jolly]

It's a drug. FDA approval needed.

[blondie]

I vaguely recall glass IV bottles. I’m sure @George-K does. I wonder if those still exist stockpiled somewhere.

[George K]

@blondie said in Severe IV fluid shortage:

I vaguely recall glass IV bottles. I’m sure @George-K does.

Sure do. They were...cumbersome.

[blondie]

@George-K I remember them for lipids. Break one and that stuff had you sliding on the floor. But, you could be real accurate reading your volumes with a glass bottle. I wonder if people today even know about that or how to count drops-calculate flow? The mental head math we all did in a day was astounding. I bet nurses today don't mix up their own meds or drips either.

[George K]

12 drops per ml. If using a mini-dripper, it's 60.

Remember, I married an ICU nurse.

I used to run dopamine, epi and isuprel (!) by counting micro drops.

And yeah, I made up my own drips too.

[Jolly]

@blondie said in Severe IV fluid shortage:

I vaguely recall glass IV bottles. I’m sure @George-K does. I wonder if those still exist stockpiled somewhere.

Africa?

[George K]

Hay, @blondie , ever see one of these?

https://bq-md.com/what-is-dial-a-flow-tubing-and-what-does-it-do/

[blondie]

@Jolly Maybe. @jodi might know, but I think glass (bottles & syringes) were still used in veterinary medicine through the 1980s. Gotta love stuff that endures.

[Jolly]

Ain't lived unless you've drawn blood donors with glass bottles. Curl their toes, you could...

[blondie]

@George-K Ive never seen that. Was that for adults? I kinda remember 20 gtts = 1 ml .. but my mind goes blank remembering how to calculate drops/min with adult drip chambers. We still put masking tape on the bags. Kids were easier with buretrols (is that what they were called?).

[George K]

Yeah, it was for adults - it "counted drops" if you will. We called it "Dial-a-guess."

We always titrated to effect, so accuracy wasn't as important as consistency.

Loved buretrols too. Had occasion to used them on adults - though not common.

[blondie]

@jolly I’ve never collected blood from a donor. That would’ve been a satisfying job I imagine.
I’m trying to remember, but could there have been a time where I stripped chest tubes into glass bottles or drained stuff coming from a chylothorax ?? lol, I seem to remember tripping or kicking over a big bottle on a floor once (and getting laughed at).