Recommendations for Managing Critical National Shortage of IV Solutions Released



4/17/2014--A new set of recommendations to help health care providers deal with ongoing and acute national shortages of certain large-volume intravenous (IV) solutions, developed by the American Society of Health-System Pharmacists (ASHP) in partnership with the University of Utah Drug Information Service, was released today by ASHP and the University, as well as the American Hospital Association and other stakeholders.

A national shortage of large-volume (i.e., 1,000 mL) IV solutions (including 0.9 percent and 0.45 percent sodium chloride injection, lactated Ringer’s injection, and 5 percent dextrose injection) has affected many hospitals and other health care sites nationwide. The shortages, which are a result of an unusual spike in demand, are not expected to resolve until May or June 2014.

“The national shortage of IV solutions is a challenging patient care issue that many of our members are having to manage on a daily basis,” said Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP, ASHP chief executive officer. “We felt it was critical to provide practical and easy-to-implement strategies to help health care providers navigate this crisis and ensure that their patients continue to receive the best care possible.”

Intravenous Solution Conservation Strategies,” which focuses on organizational, patient care, product conservation, and inventory control approaches, includes a number of wide-ranging recommendations, including:

  • Using oral hydration whenever possible,
  • Discontinuing infusions as soon as appropriate,
  • Evaluating total patient fluid requirements for surgeries to ensure the most efficient use of IV fluids,
  • Using small-volume bags for infusions that are administered at low rates.
  • Ensuring that purchasing agents have active backorders in place and are obtaining allocations as available,
  • Evaluating IV fluid supplies on a health system-wide basis in order to redeploy solutions to areas of greatest need, and
  • Implementing an organization-wide conservation plan developed in collaboration with clinicians and other organizational stakeholders.

The document also includes a list of caveats and safety information on compounding sodium chloride solutions from sterile water, ensuring that smaller IV volumes are recorded appropriately in the electronic record and labeling, and avoiding IV use of sodium chloride irrigation solution due to sterility concerns. For more information, visit

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