Addressing the IV Fluid Shortage

Bilal Ahmed, M.D.

The closing of Baxter International’s IV sterile fluid manufacturing facility in North Carolina due to Hurricane Helene led Highland and other UR Medicine hospitals to postpone certain elective surgical procedures. It also forced us to think differently about how we procure these vital fluids.

Since the Baxter closing, a multidisciplinary team has met on a regular basis — initially daily and then weekly — to respond to this situation. A variety of positions and disciplines are represented, from physicians, nurses, residents and APPs to medical/surgical floors and perioperative services, general surgery, orthopedics, urology and gynecology.

Besides pausing some elective surgeries, this team also focused on identifying alternatives to getting fluids from Baxter. We explored finding other outside sources for fluids, including international sources, but this proved too challenging to make feasible in a short timeframe.

What has been most successful are homegrown solutions to this shortage developed by the multidisciplinary team. These included substituting oral fluids for IV and repurposing fluids that we had in plentiful supply, such as repurposing Primasol for irrigation during orthopedic and urologic surgeries.

In addition to our conservation efforts, we have found ways to reduce fluid waste.

If there is a silver lining from this situation, it is that we have identified innovative ways to conserve fluids and reduce waste. We have been prioritizing IV fluids for critical patients, using smaller fluid bags, switching to oral hydration where possible, postponing elective surgeries, and closely monitoring fluid usage through electronic health records to identify unnecessary IV orders. These conservation and waste-reduction measures will remain even after the Baxter facility is back at full capacity.

Bilal Ahmed, M.D.

Associate Medical Director

 

3/3/2025