Alert: Critical IV fluid shortages continue

Michigan Medicine continues to experience shortages of intravenous (IV) solutions and medications as a result of the impact of Hurricane Maria in Puerto Rico.  

Pharmacy, supply chain and several clinicians continue to be proactive in adopting conservation measures to optimize the current supply. Alternative options for medication delivery are being implemented to maximize supplies with the least impact to clinicians and their workload. The supply interruption is ongoing, with expected shortages to last into spring 2018.

IV Mini Bags (50 and 100 ml) have been most affected (both 0.9% NS and D5% in water), but all IV solutions may eventually be at risk.

Please continue to implement the following conservation measures that apply to your clinical area:

• Do not open a new four-pack of small volume bags, if a four-pack is already opened. Please use up all four bags, as they expire within (30 days) once opened. This will help reduce waste. 

• Do not pre-order or locally stockpile IV fluids in your area; this will only exacerbate institutional shortages. Efforts to procure and institutionally store an appropriate inventory of IV fluids are taking place daily.

• Do not pre-spike IV bags or batching of fluids for procedures or daily usage.

• Alternate routes for medication delivery such as oral, IV push or syringe delivery have been implemented to conserve smaller volume bags. MiChart and Omnicell changes are being made as routes of administration change to allow for appropriate charting and medication supply.

Michigan Medicine will continue to monitor these and other expected shortages closely. Individual departments or providers may be contacted to discuss alternatives as this situation evolves. For any questions, contact Sue Friebe at sfriebe@med.umich.edu; Janine Lee at jmamatan@med.umich.edu; or Katie Barwig at kcoldren@med.umich.edu

Thank you for your continued efforts and support during this shortage.