Hospitals nationwide grapple with IV fluid shortage caused by Hurricane Helene

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• John Yang:

  It's been about three months since Hurricane Helene pummeled the mountains of North Carolina, but the effects are still being felt well beyond the storm's path. Ali Rogin explains.

• Ali Rogin:

  Whether you're dehydrated, undergoing surgery or receiving medicine intravenously, IV fluid is a staple in modern healthcare. But this past September, the nation's supply of those critical fluids took a massive hit. That's when Hurricane Helene struck North Carolina and flooded a manufacturing site owned by the Baxter Medical Technology Company. That one plant produces about 60 percent of the country's IV fluid.

  Suddenly, many hospitals felt the squeeze and were forced to delay some surgeries. It caused administrators to start to rethink how they use and conserve this valuable commodity. Jackie Fortier is a reporting fellow at KFF Health News and has been tracking this story. Jackie, thank you so much for joining us.

  Take us back to the moment when the hurricane hit. Was this impact felt immediately by hospitals who received this company's IV fluids?

• Jackie Fortier, KFF Health News:

  Absolutely. I mean, Hurricane Helene struck North Carolina in late September, as you said, flooding the largest IV fluid factory in the US and I think everyone was surprised that Baxter facility, you know, produced 60 percent of the nation's supply of IV fluids. You know, the medical folks that I talked to were all very surprised. They didn't know.

  So that factory shut down and the company began rationing its products because it was flooded. And that caused a shortage of IV fluid products you know, throughout the healthcare facilities across the US that's continuing.

• Ali Rogin:

  It's been two months since that time. I know that the facility has reopened, but is it back to full production yet?

• Jackie Fortier:

  No, no. The North Carolina Baxter factory is now making some IV fluid products, but the company hasn't announced a date when they'll be back to those, you know, pre hurricane production levels. So the IV fluid shortage is continuing. I talked to a hospital administrator in LA the other day, and they're still only getting 60 percent of their IV fluid order. So they're still down 40 percent from what they normally get.

• Ali Rogin:

  And so in the meantime, how are hospitals, other facilities, dealing with these shortages?

• Jackie Fortier:

  They're doing a lot to conserve IV fluids. And to be clear, you know, the people who really needed IV fluids have always been getting them, you know, folks who aren't able to drink. One hospital administrator in D.C. told me that they've slashed their IV fluid use by over half since the shortage began, you know, across all the hospitals that he's the administrator for.

  So, you know, sometimes that means telling emergency room patients to drink, you know, Gatorade or Pedialyte instead of getting an IV. Hospitals are switching patients from liquid medications to pills sooner than they normally would. And they're also doing some kind of common sense stuff like using up the entire IV bag before starting another. Hospitals are also giving some medications intravenously, but without a dedicated IV bag, which is known as a push medication.

  When I talked to nurses about that, they said, you know, using push medications takes more time out of a nurse's already pretty hectic schedule because they need to monitor the patient. The medicine isn't being titrated or given over time. It's kind of being given all at once.

  But, you know, the IV fluid shortage is ongoing and it could get worse as the end of the year comes up because people get sick with, you know, winter respiratory viruses. We got flu, COVID that send more people to the hospital. And then folks also schedule surgeries because their health plans usually reset in January with new deductibles.

• Ali Rogin:

  Right. And I know this shortage, this was brought on by a natural disaster, but it has made hospital administrators rethink their strategies on stocking and using these IV fluids. How might this crisis impact their decision making to make sure that something like this doesn't happen again?

• Jackie Fortier:

  I think some of the conservation measures will stick around. Some of the more kind of common sense practices, like using up an IV fluid bag before starting another. Before the shortage, when a patient was moved to a different floor, or if they came in on an ambulance and they already had an IV, it was replaced when they got to the hospital.

  Now they're keeping and using up that bag. Another hospital administrator told me that they're interested in retooling electronic health records to question doctor's orders before letting them order another IV fluid bag for hydration. So, you know, maybe a little pop up that says, does the patient really need the second bag? How do they do with eating or drinking water or juice if they did well, you know, maybe they don't need that bag.

  So these, you know, little kind of conservation mechanisms across multiple hospitals, you know, would make a significant dent and hospital administrators are really interested in conserving.

• Ali Rogin:

  How is this all affecting a patient's experience?

• Jackie Fortier:

  Well, I talked to nurses and they say that, you know, initially folks were a lot more understanding because the hurricane was in the news. And now that it's been a, you know, two and a half months, people don't really think about it as much. It's difficult for nurses too, because it does take them more time to do these push medications.

  People do ask for IV fluids if they've been, you know, in the hospital before. They know that it can make them feel pretty good. I have seen that people say that getting a push medication, again, that's without kind of the IV fluid piggyback can be painful in some cases. So we haven't seen any indication that patients aren't getting medical care that they should be getting.

  But it's difficult to get someone to drink a liter of fluid versus putting a liter of fluid in their arm through an IV.

• Ali Rogin:

  Jackie Fortier, reporting fellow at KFF Health News, thank you so much for joining us.

• Jackie Fortier:

  Thank you.

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