From: Berkley Sykes
To: Pharmacists
Sent: Tuesday, June 19, 2018 1:16:46 PM
Subject: Fwd: fluid updates

Our fluid shortage issues are looking much better. Almost all of our fluid needs may go back to "normal".

- The Pyxis pop-up **SEVERE I.V. FLUID SHORTAGE**   Please obtain discontinue order for IV Fluid if patient is taking PO. has been removed.
- LR may be ordered if desired. No need to change to an alternative.
- Sterile water looks better, so sodium bicarbonate in sterile water may be ordered. Concentrated sodium chloride is still short, so no 1/4 NS.
- It is still helpful to use NS 500 mL (BD bags) instead of NS 1000 mL, so no changes in Pyxis where NS 500 mL is loaded. 
- D5W 1000 mL are still short, so continuing to use D5W 500 mL is helpful. No changes here.

Of note:
1) Items being syringed by nursing will stay this way.
2) Dapto syringes will stay. 
3) ZOSYN 3.375 g, cefepime 2 g, and ceftriaxone 2 g will remain ADV until post-Cerner.
4) Several items changed from D5W to NS, but we're going to leave these as they are unless an issue arises.
5) Chemo flush bags have already changed back.  

Please let me know if you have any questions. 

I thank you all so much for your efforts during the fluid shortage... I know it wasn't easy, but you made a big difference!

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