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Hospitals conserve IV solutions amid national shortage

| Wednesday, April 23, 2014, 11:09 p.m.

A national shortage of intravenous solutions has led several area health care systems to put conservation measures in place, representatives said.

“Despite a nationwide shortage of certain IV drugs, we have managed our supplies so that there is no impact on patient care at UPMC,” spokeswoman Wendy Zellner said on Wednesday.

The shortage of large-volume IV solutions — including 0.9 percent sodium chloride injection, or normal saline, and 0.45 percent sodium chloride injection — has been ongoing for months.

One of the culprits is the flu, said the Food and Drug Administration.

Normal saline is administered intravenously to surgery patients and to those in emergency rooms, said Jodi Lech, oncology pharmacy specialist with the Allegheny Health Network Cancer Institute.

“Really, any patient being admitted gets some sort of IV fluid,” she said.

The shortages are not expected to resolve until May or June, according to a statement last week from the Drug Information Resource Center at the University of Utah and the American Society of Health-System Pharmacists.

The two groups recommended conserving supplies, including using oral hydration whenever possible, discontinuing infusions as soon as appropriate and using small-volume bags for infusions administered at low rates.

Several health care systems said they are conserving as much as possible.

“With the help of our physicians and pharmacists, we have adopted appropriate conservation measures — such as using oral versus IV fluids in some cases — and substituted other, more readily available items when possible,” Zellner said. “We continue to track and monitor our supplies on a daily basis and will continue to do everything possible to ensure that our patients are not affected.”

Allegheny Valley Hospital in Harrison, which is part of the Allegheny Health Network, has been experiencing a shortage since the fall, spokeswoman Linda Dalak said.

“Careful management and allocation amongst the (network) hospitals has mitigated the risk to our patients,” she said.

In January, the FDA said increased demand from hospitals in flu season triggered shortages of IV solutions, especially normal saline, which is administered for hydration and treatment.

The federal agency was working with three manufacturers to help preserve supplies, it said.

In March, the agency announced it had approved importing normal saline from a supplier in Norway.

Physicians, nurses and pharmacists are working to manage the shortage at Excela Health, spokeswoman Robin Jennings said.

“These include changing to a solution that is not in short supply, reviewing if the IV can be safely removed sooner or the rate of the IV infusion slowed,” she said.

Allegheny Health Network's 17 oncology clinics share supplies, Lech said.

“It cushions the blow a little bit. If we were just a one-office type of oncology practice, it would greatly affect us because we would have nobody to borrow (from),” said Lech, who said the network also benefits from buying power. Purchases of IV bags are based on its buying history, she said.

The network is checking to see what chemotherapy agents can be mixed with solutions other than normal saline, Lech said.

“With these types of things, you have to plan. … The last thing you want to do is have a patient that has a curative cancer not be able to get their drugs in time,” she said.

Tory N. Parrish is a staff writer for Trib Total Media. She can be reached at 412-380-5662. Staff writers Richard Gazarik and Liz Hayes contributed to this report.

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