CDC issues guidelines for IV, PD fluid shortage

The CDC issued a health advisory Oct. 12 with guidelines on how systems and leaders can manage the supply disruptions of peritoneal dialysis and intravenous solutions.

In September, Hurricane Helene significantly damaged a Baxter plant in Marion, N.C., that makes 60% of the nation's IV fluid products. Baxter said it anticipates supply allocations will rise back up to 90% to 100% levels by the end of the year, with nationwide supply disruptions likely to linger until then, according to an Oct. 9 company press release.

"Healthcare providers, pharmacists, healthcare facility administrators, and state, tribal, local, and territorial health departments, regardless of supply chain disruptions, should immediately assess their supply and develop plans and mitigation strategies to reduce the impact on patient care," the CDC said. "The supply disruption may impact patient care and require adjustments to the clinical management of patients."

Here are 10 recommendations for IV and PD fluid conservation:

For healthcare providers, administrators and pharmacists in healthcare facilities:

1. Assess inventory, supply and conserve available IV solutions.
   
   
2. Report any potential shortages or interruptions to the FDA.
   
   
3. Implement a facility-specific action plan to optimize the use of IV solutions using evidence-based fluid management protocols. This includes evaluating all protocols, using oral formulations when IV options are not available, identifying safe alternatives, and ensuring thorough documentation of the situation.
   
   
4. Utilize a multidisciplinary team to determine and develop conservation and stewardship strategies.
   
   
5. Communicate changes in practice, disruption, new shortages and action plans to hospital leadership, frontline staff and patients.

Recommendations for providers and administrators of dialysis facilities:

1. Assess and monitor inventory of PD solutions and report any interruptions to the FDA.
   
   
2. Implement an action plan for emergency PD treatment protocols.
   
   
3. Ensure optimal PD catheter function and flow of all patients, optimize prescriptions and monitor patients closely after prescription adjustments.
   
   
4. Communicate with patients receiving peritoneal dialysis at home, including assessing supplies, providing education and considering alternative options. Reinforce patient safety principles when not using usual products and procedures.
   
   
5. Continuous ambulatory PD may be a good option for some patients. Transitioning to hemodialysis should be avoided where possible. Reinforce patient safety principles when not using usual products and procedures.