From: Berkley Sykes  
Sent: 15 February, 2018 7:31 AM
To: Pharmacy
Subject: Fwd: diluent vial shortage and new 500 mL fluid
Attachment: Flier - Adult Administration of Select Antibiotics via IV Push
VA8930 IV Fluids Instructions to Use Tipsheet R1

Nursing received the information in the email below today. 

New 500 mL fluid available:
We will soon be changing the use of plain fluid NS and LR (some) liter bags to NS 500 mL bags. 
We have no D5W 1000 mL bags, so we will use D5W 500 mL bags instead. 
Please note the new fluid bags have caps on the ports: white for adding medication and blue for attaching a set. 

Please let me know if you have any questions or if your nurses are having issues. 

Thanks!
Berkley

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

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From: Berkley Sykes
To: Unit Directors, Education Council
Sent: Thursday, February 15, 2018 7:24:31 AM
Subject: diluent vial shortage and new 500 mL fluid

Diluent vial shortage:

Sterile Water: Due to effects from the fluid shortage, the supply of SW 10 mL vials (and other small sizes) has been depleted. It is now necessary to use NS to reconstitute vials for IV push. All of the recent antibiotic IV syringe additions are compatible in NS, but the 5-10 minute rate must be adhered to in order to avoid/reduce phlebitis. When SW returns to market, it is the preferred diluent. 

Normal Saline: The stock of NS vials is very low. In the near future, it may become necessary to use NS flush syringes to reconstitute vials for IV push. 

Important: 
1) Cover the saline syringe label/barcode with medication label. Pyxis labels are available.
2) The ONLY reason the use of flush syringes for reconstitution is permitted is because this is an emergency situation due to the shortage, and the use of flush syringes will be temporary. 

See attached flier for updated instructions, and replace previous fliers as needed. 

New 500 mL fluid available:
Purchasing has acquired NS and D5W 500 mL bags from Fresenius Kabi to supplement our large volume bags during the shortage. You may see these ordered instead of 1000 mL bags. See the attached flier for instructions for use. 

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