From: Berkley Sykes
To: Pharmacists
Sent: Tuesday, December 5, 2017 12:35:45 PM
Subject: fluid shortage

The fluid shortage continues to worsen and to change. The Puerto Rico facilities manufactured small bags and mini-bag plus (MBP), but we have also had shortages on large volumes. At this point, I know of no fluid that isn't either short or has a tight allocation in place.

Because of this, I ask you to do two things to help us out.

1) Consider your areas and your patient orders: Are there any drugs that are given as an IVPB that could safely be pushed? For example: Brittney has heard of some hospitals giving dexamethasone 20 mg as a push, but very slowly as to avoid side effects. If you have some ideas, but need to talk it through, feel free to call me.
2) Large volume boluses, KVO, and other uses: Are these really necessary in every case? Can we get these d/c? Sadly, we don't have a great alternative... I'd love to say use 1000 mL instead of 500 mL, but we are hearing of liter bag shortages in other hospitals and want to be cautious. Consider OR and other ancillary units as well... some areas utilize these fluids in ways we may not know.

Purchasing has been working very hard to keep us from running totally out of fluids, but there's only so much they can do. If we can do our part by lowering our usage, we can perhaps extend the life of the supply we have.

Let me know your ideas!

Thank you for your help and your patience, Berkley

Berkley Sykes, Pharm.D.
Pharmacy Manager - Sterile Products Services