SODIUM PHOSPHATE SHORTAGE

We are experiencing another sodium phosphate shortage and we have an approximate 7-day supply on hand. Please follow the conservation measures below.

-If patient is able to tolerate NG or PO route, NeutraPhos packets should be selected:

 2 packets Neutra-Phos q 6 hr x 5 doses = 40 mmol absorbed phosphorus

 2 packets Neutra-Phos q 6 hr x 4 doses =  32 mmol absorbed phosphorus

 2 packets Neutra-Phos q 6 hr or q 8 hr x 3 doses =  24 mmol absorbed phosphorus

 2 packets Neutra-Phos q 6 hr or q 8 hr x 2 doses = 16 mmol absorbed phosphorus

- Remove sodium phosphate from all adult TPNs in order to preserve our supply for neonatal patients. Utilize potassium phosphate instead, where appropriate (evaluate serum K, renal function).

- In patients with a normal serum potassium, requiring phosphate repletion, utilize IV POTASSIUM phosphate instead. If the patient has a CRITICALLY low phosphate level and cannot tolerate the potassium salt, whether due to existing hyperkalemia or a combination of potassium level and renal dysfunction, you may consider using sodium phosphate. 

- If using POTASSIUM Phosphate, watch for additional Potassium CHLORIDE boluses . Patient likely will not need both POTASSIUM phosphate and potassium CHLORIDE.

    * 45 mmol Potassium Phosphate = 66 mEq Potassium

    * 30 mmol Potassium Phosphate = 44 mEq Potassium

    * 15 mmol Potassium Phosphate = 22 mEq Potassium

We are hopeful to receive a shipment in early to mid November. We will notify you when our supply is restored.