What does that look like? What kind of patient or situation that would usually get fluids, are not getting them? Who are top priority and is there enough for them — for example, are septic shock or other hypotensive patients still always getting IVF?
I think I remember reading about a shortage of iv fluids just a few years ago. For resiliency, production needs to be more widely dispersed and some redundancy planned within the system. Just saw a story about infant formula shortages again. Things look deceptively functional until a crisis and then it becomes apparent that they are a mile wide but only inches deep. whomever does strategic planning, they are repeatedly inept , don’t have their priorities straight or both
EM/CCM - In the ED we’re pivoting hard to oral rehydration. Patients inappropriate for that (shock, cannot tolerate PO), still can receive crystalloid. On the floor, MIVF (dubious at baseline) is restricted to 24 hours. We have surgical and procedural guidelines encouraging po hydration prior to procedures up to 2 hours prior to procedure.
Obviously this is bad and a product of market consolidation creating extreme medical vulnerability. That said, if this can normalize oral rehydration over unnecessary IV and reduce NPO times prior to procedures, there may be positive outcomes.
Thank you again for posting this. There clearly needs to be a federal watch-dog organization to use AI and other skills to figure out other such potential issues and then the federal government needs to make sure that such critical supplies are not so vulnerable so that one factor cannot single handedly have the potential to shut down the entire healthcare system. This is critical, though this country does not have the appetite for such regulation as regulation is alway seen as “bad”.
I can see this falling under the Defense Dept. Making sure there are multiple sources. Subsidizing / funding some of the facilities if they are not profit making. It’s a national security issue.
We are rationing.
What does that look like? What kind of patient or situation that would usually get fluids, are not getting them? Who are top priority and is there enough for them — for example, are septic shock or other hypotensive patients still always getting IVF?
I think I remember reading about a shortage of iv fluids just a few years ago. For resiliency, production needs to be more widely dispersed and some redundancy planned within the system. Just saw a story about infant formula shortages again. Things look deceptively functional until a crisis and then it becomes apparent that they are a mile wide but only inches deep. whomever does strategic planning, they are repeatedly inept , don’t have their priorities straight or both
EM/CCM - In the ED we’re pivoting hard to oral rehydration. Patients inappropriate for that (shock, cannot tolerate PO), still can receive crystalloid. On the floor, MIVF (dubious at baseline) is restricted to 24 hours. We have surgical and procedural guidelines encouraging po hydration prior to procedures up to 2 hours prior to procedure.
Obviously this is bad and a product of market consolidation creating extreme medical vulnerability. That said, if this can normalize oral rehydration over unnecessary IV and reduce NPO times prior to procedures, there may be positive outcomes.
Well said! Being forced to take a fresh look at established habits and practices can (accidentally) result in positive change.
Thank you again for posting this. There clearly needs to be a federal watch-dog organization to use AI and other skills to figure out other such potential issues and then the federal government needs to make sure that such critical supplies are not so vulnerable so that one factor cannot single handedly have the potential to shut down the entire healthcare system. This is critical, though this country does not have the appetite for such regulation as regulation is alway seen as “bad”.
I can see this falling under the Defense Dept. Making sure there are multiple sources. Subsidizing / funding some of the facilities if they are not profit making. It’s a national security issue.
I agree with you 100%. We all know that there must be similar other such vulnerabilities out there.
ruh roh