Some ER patients are half as likely to get IV fluids since Hurricane Helene disruptions | CNN

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Patients visiting emergency departments for dehydration or nausea are half as likely to receive IV fluids now than they were when Hurricane Helene increased supply shortages, according to a review of health records. beauty of Truveta Research.

When the storm hit western North Carolina last month, it caused flooding and other damage has halted production at Baxter’s North Cove manufacturing facility. The region supplies nearly 60% of IV fluids to hospitals across the US, and the disruptions have led to several new shortages.

The US Centers for Disease Control and Prevention said earlier this month that “supply disruptions could affect patient care and require changes in patient management.” To reduce the impact on patients, federal agencies and professional associations have recommended that health care providers develop resource conservation practices, including substituting oral hydration such as Gatorade or Pedialyte whenever feasibility and ongoing assessment of clinical need for IV fluids.

Changes were visible in just over a week, Truveta’s analysis suggests.

The team analyzed nearly 350,000 emergency department visits for patients age 12 and older who were admitted for dehydration or nausea or vomiting between January 1 and October 13.

It found that an average of 6.6% of patients admitted to the emergency department with dehydration were given IV saline in the months before Hurricane Helene. But 10 days after the storm subsided, IV administration rates dropped to about 2.5% for these patients. Similarly, for those admitted with nausea or vomiting, rates of IV fluid administration dropped from an average of 5.5% to 2%. These trends were consistent across age groups.

IV fluids are used for many medical purposes. Others, like dehydration, can be helped by other methods. But others, like transplant surgeries, can’t.

Conservation strategies, such as substitution for patients who can tolerate oral alternatives, are one of the many levers being pulled to help ensure that these valuable resources remain available to those who need them most, said Dr. Chris DeRienzo, chief physician officer of the American Hospital Association.

“These conservation efforts make a huge difference in helping ensure that patients who have no other option, we get the supplies we need,” he said. “Every patch we put on this patchwork quilt to try to cover the 60% hole helps.”

Other initiatives are also increasing the scale of the supply chain. On Monday, the US Food and Drug Administration announced that it has extended expiration dates for many products manufactured before the hurricane hit. The agency has also allowed the temporary importation of products from other facilities outside the US to help reduce the shortage, and some US manufacturers – B Braun Medical and ICU Medical – have increased production to help fill gaps.

But getting the supply chain back to full capacity will take time. The first shipment of IV fluids began arriving by plane about a week ago, but there is a “variable timeline” when retailers can begin receiving new shipments, Baxter said in a statement. Baxter also expects to start some production at its plant in western North Carolina this week, but notes that additional supply won’t reach suppliers for several more weeks.

“We carefully manage the availability of both pre-finished goods from North Cove and the importation of the product into the US,” the company said.

Meanwhile, many hospitals are working with command centers that focus on making real-time decisions about food supply.

“We’ve seen optimism about supply increases, but you can’t plan based on optimism,” DeRienzo said. “So until you start to see that increased distribution is constantly appearing in your port, it becomes more difficult to plan for the longer term than the time that the command center helps you manage.”

And the seasonal threat of the respiratory virus continues. People with severe respiratory conditions are some who cannot normally tolerate oral medication.

“There’s certainly a concern that as efforts to repair the supply chain continue, we’re also running into the timing that viruses outside of our control dictate,” DeRienzo said.

But patients shouldn’t worry that their care will be cut short, he said: “We’re in the middle of some conservation efforts that have a big impact on consumption, but this whole job is to make sure that we [IV fluids] for patients when they need them.”