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With Saline in Short Supply, Hospitals Look for Alternatives

Lena J. Weiner, for HealthLeaders Media, May 16, 2014

'Very Serious' Shortage
Erin Fox, PharmD, director, Drug Information Service, University of Utah Hospitals and Clinics, characterizes the saline supply problem as "very serious. It's serious when clinicians have to make a decision to use an alternate product. A big part of the treatment plan now has to be asking, 'is that product available?'"

Until recently, saline solution was routinely taken for granted. Jaspan recalls that it used to be standard practice to use a 1000 milliliter bag of saline solution in any situation calling for an IV in order to avoid refilling it.

"You used what you needed and tossed what was left at the end of day. A lot of people are used to doing that," he says. Now staff at his hospital are conserving saline by using smaller bags and changing them frequently.

"If you just need to keep a vein open, you can use a 250-milliliter bag rather than a larger one," he says.

Another way Jaspan's team has been coping with the shortage has been by formulating substitutions. "We can use Dextrose 5% and half-normal solution in saline's place," he says.

Jaspan has other tricks to make sure patients get the right solution, too. "If there's no half-normal solution available for the patients who need it, pharmacists can compound that [in house]. You just take sterile solution with sodium chloride added. Need Dextrose? We'll find a way to compound that as well."

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3 comments on "With Saline in Short Supply, Hospitals Look for Alternatives"


Janet Mlinar (5/20/2014 at 1:32 AM)
I agree with making or at least storing large quantities of IV saline in hospital pharmacies. Along with reusing the same IV bag with the same patient. As long as sterile refills are applied. We have a growing population of people worldwide. Part of keeping up with this demand is having large quantities of what we know we will need at hand or at least having the capability of making or compounding medications as needed.

MB Rosenstiel, RN, DNP (5/16/2014 at 2:38 PM)
Seems to a clear move to increase the cost of a relatively inexpensive healthcare item to me. Perhaps it is time for pharmD's to compound in-house and use all the education they recieved. Might actually be less expensive and safer in the end!

David Morledge, PhD (5/16/2014 at 10:27 AM)
A broken system. Clearly we need a national security initiative related to basic healthcare supply systems, with requisite manufacturing in the U.S.