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05/12/17 DC -- IV bicarb status - PLEASE READ

From: David Collette
To: Pharmacists
Sent: Friday, May 12, 2017 9:58:42 AM
Subject: IV bicarb status - PLEASE READ

We had a conference call this morning with Dr. Chappell, Jeff Samz, and several physicians regarding the bicarb shortage. Our supply of injectable sodium bicarbonate continues to dwindle with no release date available for new product. Our current supply is approximately 1,275 vials and syringes , which (at current usage rate) will last < 4 weeks.

During this call, the following was decided:

    * Na bicarb will NOT be used in Code-0 situations . It has been removed from crash carts and Dr. Chappell said that it should be removed from pharmacist's code boxes and non-ICU Pyxis machines
    * The group also felt concluded that bicarb will be restricted to oncology, CV and Trauma OR, and possibly some ICU patients with clinically significant documented metabolic acidosis.
    * Dr. Chappell will talk to Dr. Wellborn and Knott from Valley Vascular about NOT using bicarb in their patients
    * Every single IV bicarb order must be scrutinized closely and only provided to patients meeting these criteria. Contact the MD/PA/NP for orders not meeting this criteria, explain the situation, and offer options where appropriate. We have a plentiful supply or bicarb tablets (7.7 mEq each) as well as Bicitra liquid (citric acid + sodium citrate)

Thanks to everyone who has helped us deal with this critical shortage. We are exhausting all avenues in trying to maintain our IV bicarb supply and appreciate your assistance.
 
DAVID
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David R. Collette, Pharm.D., FASHP
Operations Manager, Professional Services
Huntsville Hospital Department of Pharmacy