As a way of providing easy to access information to our hospital and surgery centers PREFcards has
compiled this list of ideas and recommendation on managing the current shortage of IV fluids,
products, and saline bags.
This fact sheet is based on publicly available best practices. It is provided for informational purposes
only, without liability for its accuracy or completeness.
If your hospital or healthcare site is facing or expecting a shortage of IV fluids, electrolytes, or amino
acids, here are 7 steps to help manage the situation:
1. Switch medications from IV to oral (PO) form when possible.
o Consider implementing an IV to oral protocol. Common medications for conversion
include antibiotics, antiepileptics, proton-pump inhibitors, and vitamins.
2. Administer antibiotics by IV push.
o Many antibiotics, such as beta-lactams, can be given as small-volume IV push instead
of IV piggyback.
3. Preserve unused IV fluids.
o Switch fluids before the current infusion is finished and use the remainder before
starting a new bag. Educate nursing staff to keep unused fluids spiked and primed until
they expire.
4. Assess the need for IV versus oral electrolyte replacement.
o Reserve IV electrolyte replacement for life-threatening cases or patients who can’t do
oral replacements. Use enteral methods for electrolytes if possible
5. Set clear guidelines for using intravenous electrolytes.
o Base replacement on serum levels (e.g., phosphorus levels below 1.6 mg/dL).
6. Update the electronic health record (EHR) to support smart prescribing if possible.
o Use alternative diluent bag sizes, and add alerts when supply is low or restricted.
7. Use enteral hydration instead of IV for patients with a functioning GI tract who are not critically
ill.
o Available products could include Oralyte Oral or Pedialyte.
More information can be found at these links
https://www.ashp.org/drug-shortages/shortage-resources/publications/fluid-shortages-suggestions-for-management-andconservation?loginreturnUrl=SSOCheckOnly
https://www.baxter.com/sites/g/files/ebysai3896/files/2024-10/9-30_Medical%20Information%20Letter.pdf
https://www.acr.org/Media-Center/ACR-News-Releases/2024/ACR-Guidance-on-Potential-Shortage-of-IV-Products-andSaline-Bags