Some Washington hospitals have temporarily halted elective procedures this week, as they struggle with IV fluid shortages caused by Hurricane Helene flooding and damage.
The storm coursed through the southeastern United States late last month, killing more than 200 people, wiping out electricity and cell service, and causing significant damage in several states including to a key Baxter International plant in North Carolina. The medical supply facility produces about 60% — or 1.5 million bags — of IV saline solutions used daily in the U.S., meaning a large part of the country’s hospitals, EMS providers, long-term care facilities, and surgery and dialysis centers could see shortages as long as the Baxter plant faces disruptions.
Hurricane Milton, which made landfall Wednesday evening, will likely add more challenges as it hits Florida, home to the nation’s second-largest IV fluid manufacturer, B. Braun.
“Washington’s hospitals have worked together to face past challenges, and this issue is no different,” Cassie Sauer, president and CEO of the Washington State Hospital Association, said Wednesday in a written statement. “We will work together to ensure lifesaving care remains available.”
While it’s not clear how many hospitals have paused or postponed elective procedures, WSHA confirmed that all hospitals have started implementing conservation strategies and are currently managing their own IV fluid supplies.
“Although delays are disruptive, hospitals are continuing to provide critical services,” Sauer said in the statement. “However, the longer procedures are delayed, the sicker patients can get. It is not an acceptable long-term solution.”
Some ways hospitals are conserving fluids include dividing larger bags into smaller ones and using them for patients who might need less, Sauer said in a Wednesday call. Hospitals also might try hydrating patients orally instead of intravenously, or giving patients other forms of medication — like a shot or pill — though those strategies depend on the patient, she added.
“Usually, IV solutions are not something hospital personnel are accustomed to having a shortage of,” Sauer said. “This is a mindset shift.”
Forks Community Hospital on the Olympic Peninsula is among those that rely on Baxter for IV and peritoneal dialysis solutions. According to a Facebook post this week, the hospital has been forced to suspend all elective or nonemergent procedures while delays last.
The hospital will provide IV fluids if medically necessary, the post said, but noted it’s “important that we conserve our limited supply for those with an urgent medical need.”
“We will continue to monitor this national IV supply shortage and provide updates as often as possible,” Forks Community Hospital said.
Sauer said she didn’t know exactly how many hospitals in the state rely on Baxter IV fluids, but that “everyone uses at least some.”
IV fluids have a wide range of uses in hospitals, including to prevent or treat dehydration or electrolyte imbalances in emergency departments, operating rooms and intensive care units, Sauer said. They can also be used to treat sepsis and stabilize surgical patients, and can be mixed with medications to be administered more slowly than an injection might, she said.
Washington health care systems are also leaning on each other for support and to exchange information, said Onora Lien, executive director of the Northwest Healthcare Response Network, a statewide coalition of health care systems. Earlier Wednesday, Lien joined a call with hundreds of other health organizations throughout the state to better understand impacts to different types of facilities, and how they could perhaps help each other.
Some larger systems with a greater supply of IV solution, for example, might be able to share resources with smaller, more rural dialysis centers or hospitals, Lien said.
“That degree of collaboration is really unique in our state, and something we should be proud of,” she said.
Despite supply challenges, Lien reiterated that patients should continue to seek medical care if they need it. As of Wednesday, she was not aware of any emergency patient transfers between hospitals or other health care facilities due to IV fluid shortages — though the need could arise, especially among critical-access hospitals, she said.
State health care leaders, including those at WSHA and the Northwest Healthcare Response Network, are in contact with state and federal agencies to keep them updated on hospitals’ status and “to urge their quick and focused help to secure additional supplies,” WSHA said.
In a Monday letter to President Joe Biden, the American Hospital Association underscored the need for federal support, and asked the administration to declare a national emergency and a shortage of IV solutions, which would free up some resources.
Patients across the country will feel deepening effects of the IV fluid shortage in the coming weeks “unless much more is done to alleviate the situation,” AHA President Richard J. Pollack wrote in the letter.
The U.S. Department of Health and Human Services on Wednesday released a letter to health care leaders, confirming that Baxter has since resumed shipments to hospitals and dialysis providers after its temporary hold last week, but that supply might continue to be strained in the coming weeks.
Until its facility in Marion, N.C., is back up and running, Baxter is planning to increase production at its other global plants to meet demand in the U.S., HHS Secretary Xavier Becerra said in the letter.
However, because the agency’s Administration for Strategic Preparedness and Response has identified the possibility of Hurricane Milton “further disrupting an already fragile market,” Becerra said teams are quickly working to move supplies away from the storm’s project path.
Lien said he does not know of any IV fluid manufacturers in Washington.
“Long term, this is something we’d like to see more diversity in,” Lien said.
