From: Berkley Sykes
To: Pharmacists
Sent: Tuesday, March 20, 2018 1:50:07 PM
Subject: Fwd: URGENT - please read re: fluids/TPNs

To reiterate what David stated below, Logistics is still out of LR. In order to have enough LR in stock for L&D and hopefully some procedural areas, we must change all orders for LR to NS... this includes ED. If we do not, we will run out of all LR. 

Please let us know if you have questions or issues. 

Thanks,

Berkley

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

---

From: David Collette
To: grp allpharm
Sent: Friday, March 16, 2018 5:23:01 PM
Subject: URGENT - please read re: fluids/TPNs

Shortages keep hitting us hard and there are a couple that have reached critical status:

    * We are critically low on 1,000 and 2,000 mL sterile water bags. At our current usage rate, we will exhaust our supply in <3 weeks and will have no sterile water for TPNs or drug reconstitution. It is imperative that you get ALL POSSIBLE TPNs stopped over the weekend. If there is any possibility at all that the patient can meet his/her needs enterally (orally or via tube), they must be switched to this route. Also, please remember that most non-trauma adult patients who are in decent nutritional status can go 5-7 without eating with little or no consequences.

    * Logistics is out of LR and we do not know when they will receive further stock. At this time, we must switch all LR patients (except L&D) to NS (this interchange was approved by P&T and can go both ways during a shortage).

I will put this information on Pulse, email to nurse managers and charge nurses, and have Med Staff Office blast out to physicians. Since it is Friday evening, many nurses and physicians may not see the posting until next week, but we must take these steps NOW. If you have any questions or need me to talk with a physician, do not hesitate to contact me.

DAVID
--
David R. Collette, Pharm.D., FASHP
Operations Manager, Professional Services
Huntsville Hospital Department of Pharmacy