'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."