Facing the Shortage of IV Fluids — A Hospital-Based Oral Rehydration Strategy

• 2024

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• Andrés Patiño; Regan Marsh; Eric Nilles; Christopher Baugh; Shada Rouhani; Stephanie Kayden
PMID: 29561701DOI: https://doi.org/10.1056/nejmp1801772

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Puerto Rico, a major producer of IV fluid bags for the U.S., faced a critical shortage after Hurricane Maria in 2017, leading to a nationwide shortage. The complex production process, limited manufacturers, and group-purchasing organizations contribute to the vulnerability of the IV-fluid supply. To address this shortage, a hospital developed an oral rehydration protocol for patients with mild dehydration, reducing the reliance on IV fluids. The protocol involves structured drinking goals, patient involvement, and monitoring. Early data shows a decrease in IV-fluid use with the protocol. This protocol could serve as a model for other U.S. hospitals facing similar shortages.

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Tags

Hazards: Everyday Emergency; Infrastructure Failure

Audiences: Emergency Managers; Physicians

Emergency Management Stage: Response

Keywords: Clinical Protocols; Fluid Therapy; Infusions, Intravenous; Rehydration Solutions; Sodium Chloride

Institutions: Massachusetts General Hospital; Brigham and Women's Hospital; Harvard University; Partners in Health

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