The IV supply crisis: What ASCs need to know 

Amid the fallout from Hurricane Helene, hospitals across the nation are conserving IV fluids.

Here are nine things to know: 

1. Flooding from Hurricane Helene damaged Baxter’s manufacturing plant in Marion, N.C., which supplies around 60% of the U.S. market's IV fluids. On Oct. 3, Baxter informed customers they would only receive 40% of their typical IV fluid orders due to the damage.

2. By Oct. 9, Baxter had increased allocations to 60% of normal levels, citing anticipated shipments from its foreign facilities. In a news release on the same day, the company said allocations for IV solutions and nutrition products for designated children's hospitals were increased to 100% due to the vulnerable population the facilities serve.

3. On Oct. 8 Baxter said it has resumed shipments of IV products to hospitals and dialysis patients after a temporary weeklong suspension. The company also revealed it was inspecting its finished products to support current distribution levels. Baxter's global manufacturing plants have ramped up production to meet U.S. demand, with expected product deliveries continuing throughout October.

4. More than 86% of U.S. healthcare providers are experiencing IV fluid shortages, according to a Premier survey published Oct. 10. More than half of respondents said they had 10 days' worth of supplies or less on hand, and some smaller providers noted they had received none of their requested supplies.

5. The shortage is forcing hospitals to make difficult choices regarding patient care, the New York Times reported Oct. 9. In Chicago, physicians from Northwestern Medicine have been working to secure IV fluids for nearly 90 patients in their home dialysis program. Additionally, almost 17% of surveyed providers have canceled elective surgeries and other procedures due to the shortage, while 58% are considering similar measures, according to the survey. 

6. On October 7, the American Hospital Association called on President Biden to declare the IV fluid shortage a national emergency, citing severe difficulties for healthcare providers across the country. The American Society of Health-System Pharmacists echoed the call Oct. 8.

7. Most recently, the FDA said it might temporarily allow the importation of IV fluids from overseas to alleviate the shortage caused by Hurricane Helene. An FDA spokesperson said, "We are expediting the evaluation of new sites and manufacturing lines, actively considering temporary importation, and will take necessary regulatory actions, including those needed to help Baxter's North Cove plant recover."

8. HHS Secretary Xavier Beccera said in an Oct. 9 letter to healthcare providers that around 400 federal workers would be deployed to help communities recover from Hurricane Helene. He also said the department is coordinating with Baxter to ensure staff safety and mitigate the supply shortage.

9. Experts have raised concerns about the over-concentration of critical supplies like IV fluids in a few manufacturing locations. Tom Cotter, executive director of Healthcare Ready, emphasized the need for greater investment in supply chain resilience. "There is an increased need to widen the scope of what we think is vulnerable in our medical supply chain," Mr. Cotter told the Times Oct. 9

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