COMMENTARY

The IV Bag Shortage: An Overlooked Solution

Arefa Cassoobhoy, MD, MPH

Disclosures

April 23, 2018

Hello. I'm Dr Arefa Cassoobhoy, a practicing internist, Medscape advisor, and senior medical director for WebMD. Welcome to Medscape Morning Report, our 1-minute news story for primary care.

Forty-four percent of our intravenous (IV) fluid bags are produced in Puerto Rico, and due to Hurricane Maria, the nationwide shortage is worsening.

A group of emergency room doctors implemented a protocol utilizing oral rehydration solution in lieu of IV fluids.

The protocol is for adults with mild dehydration, ranging from acute gastroenteritis to pregnancy-related hyperemesis, mild upper respiratory infections, and pharyngitis.

The patient is provided 500 -1000 mL of fluids, a straw, and a 30-mL cup. The sips are timed and the progress is tracked.

Previous research has shown that oral rehydration therapy can reduce diarrheal illness mortality by 93%. It's also cost-effective and reduces hospital admissions and length of stay.

What is also encouraging is that 1 week after starting the protocol, the hospital saw a 30% reduction in volume of IV fluids used.[1] And 2 weeks later, 15% fewer patients had IV fluid orders.This low-cost, evidence-based solution may be here to stay as a new standard of care.

Follow Dr Cassoobhoy on Twitter at @ArefaMD

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