Skip to comments.National Shortage of Normal Saline
Posted on 01/11/2014 1:13:07 PM PST by bkopto
How is this shortage of Normal Saline going to affect your facilities?
I hear that Baxter may have production levels back to normal on the 17th January? This has the potential to be detrimental to our dialysis patients.
Fresenius are also experiencing a shortage of saline
Are your facilities making back up plans?
I hear that hospitals will be affected too!
Some of the units I work with use a vast amount of Normal saline per day
What I want to know is how are these 'drugs' in short supply?
Normal Saline, seriously how can this happen!
(Excerpt) Read more at allnurses.com ...
The following is from the National Renal Administrators Association:
"Many of our members have received notice from Fresenius Medical Care of North America regarding the critical shortage of normal saline. Due to Customs import detention issues by the Food and Drug Administration (FDA), they are unable to meet the current demand for normal saline.
"As you may know, normal saline is an essential component in the treatment of patients requiring life-sustaining dialysis therapy. The interruption in the supply of this product will affect the treatment of and access to care for ESRD patients across the country."
(from http://origin.library.constantcontact.com/download/get/file/1107293291594-111/NRAA+-+Saline+Shortage+-+FDA+-+2013-09-17.pdf )
The following is from an email the pharmacist at my hospital sent to everyone:
"The Normal Saline (NS) shortage continues. Thank you for all your hard work and diligence to reduce our usage.
Please continue to use Lactated Ringers or other IV fluids if clinically appropriate. Pre-mixed fluids of NS containing potassium and D5 are available also.
Because of the impact this has on the supply of all IV fluids, please discontinue IVs and TKO IVs as appropriate
NS in 250 mL bags are available to the floors to utilized for boluses and urgent/emergent situations.
Additional updates will be sent as more information becomes available. Please contact me if you have any questions or concerns.
Your conservation efforts are greatly appreciated."
Probably gleeful Obama aids holding up deliveries to punish states with governors not subscribing to Medicare expansion. IVgate.
With very few exceptions most of the calamities of starvation or deprivation have been caused by communist policies. That includes the shortage in this country of flu vaccine. Probably 100,000,000 deaths in the twentieth century were caused by deliberately bad policies, the Russian wheat shortage, for example.
Policies are not generally intended to cause calamity. But that is the result. It’s always the result when people who don’t understand economies try to make them work the way they think they should work rather than how they do work.
That was what happened when the farms were turned over to the peasants, instead of the land owners who knew how to farm.
Has me thinking of unacceptable or even dangerous Chinese imports unless I'm reading between the lines wrong.
“That was what happened when the farms were turned over to the peasants,”
They weren’t really turned over. Those peasants in Russia were on a tight leash. It was the over control and the loss of a real a marketplace that destroyed the farms. But the Ukrainian disaster was deliberate by Stalin to get rid of the kulaks. Twenty million died.
They were all but slaves
Why are we importing Saline?
Salt water? W-T-F America?
Something really wrong here folks when we can’t even make salt water.
Not enough information in the article so I did a search.
According to a pharmaceutical site, Yup, bad Chinese stuff.
You also are correct. Sum Ting Wly Wong
- 18 years between autoclave cleanings of surgical instruments.
Use coconut water instead, problem solved.
Find that 40 S&W ammo, and you will find the saline.
Where was this?
Especially with global warming and the sea levels on the rise.
Fresenius announces shortage of 1-liter normal saline product
September 18, 2013
“Fresenius Medical Care North America announced that there is a temporary shortage of its 1-liter normal saline product. Because of its high market demand the, Fresenius Medical Care 1-liter 0.9% sodium chloride saline product (SKU: 060-10109) is in short supply. The shortage is the result of an issue with customs affecting their production facility in Guadalajara, Mexico, which normally handles the increased demand for the product.
Fresenius said it has implemented a new order entry control and are also investigating secondary suppliers. Orders will be limited to one weeks worth of product at a time based on historical ordering patterns unique to each business, Fresenius said. “We anticipate this being a short-term issue and that we will be able to return to standard ordering procedures within the next few weeks,” according to a memo from Fresenius.
The National Renal Administrators Association sent a letter to the U.S. Food ad Drug Administration encouraging them to help make sure the matter is resolved safely and expeditiously. In response, the FDA stated their belief that the shortage issue has been resolved. The NRAA encourages members to continue to look for alternative sources of saline while the resolution process is taking place.”
FOUR MONTHS ago!?!
FDA heads need to roll. If there are problems with this particular supplier the the FDA should have others ready to meet the need. What did they do, turn the problem over to FEMA?
Are you serious? “Coconut water?”
just the other day I came across an article tying a middle eastern company named Hikma with Baxter pharm. I’m not one that follows business news but this didn’t sit well with me.
Cue Roberta Flak.
Miramichi Regional Hospital, Horizon Health Network, New Brunswick, Canada
My mistake. It was 14 years, not 18 years. So it wasn't really as bad as I made out.
You can make it at home:
How to Make Normal Saline
This recipe for normal saline will save you money and allow you to fix the
amount you need. Other names for this solution are boiled salt water, sodium
chloride 0.9% solution, or isotonic sodium chloride. Normal saline is used for
cleaning wounds, suctioning, tracheostomy care and other treatments.
C Table salt (plain, not iodized) C Sterile jar with lid C Measuring cup
C Measuring teaspoon C Pan with lid C Timer or clock
Steps to follow:
C Wash your hands well with warm water and soap. Rinse with warm water and
C Get your supplies together.
C Wash the pan and lid with mild soap and water. Rinse well with water.
C To make one (1) quart (32 ounces or 1000 ml), measure 4 cups of tap water
and pour it into the pan.
C Add 2 level teaspoons of table salt to the water.
C Cover the pan. Bring the water to a boil and boil for 15 minutes. Be sure to
keep the lid on the pan.
C Remove the pan from the heat. Keep the lid on the pan while the normal saline
cools to room temperature.
C Pour the normal saline into a sterile jar. Close the jar tightly with a sterile lid.
C Label the jar with the date and time the normal
saline was made. Also mark the date and time
you should throw away or discard any that is
left in the jar. This would be 48 hours after
you open the jar. Here is an example of a
C Throw away unopened jars of normal saline one month after you prepared
Department of Nursing
The Ohio State University Medical Center
This is from a home nursing guide for patients. Just google how to make normal saline. It is a .pdf
“Use coconut water instead, problem solved.”
Really?...You first, let us know how it works out for you.....if you survive.
The sodium chloride used in IV solutions must be 100% pure. It also must be low iron. USP rules. A liter of NS costs about eighty cents.
Oops, forgot the link
I see a commenter already noted that this opens the door to low (or no) quality Chinese imports.
But reading about how people have been turned away from hospitals without treatment because of Obamacare snarls that make obtaining authorization impossible, and now saline shortages, I wonder if they are trying to “prove” that Obamacare cuts costs? Or create a firestorm of complaints that they “offer” to solve with single payer? Or all of the above.
Only uneducated guess I can make: Perhaps because there is so no money in it?
National Shortage of Normal Saline
Thanks, Slings and Arrows.
People are so fussy nowadays.;-)
Oh, I shed a tear....
I would suspect someone has developed a method of turning it into some type of drug that can be smoked, snorted, or shot up, thereby causing the shortage.
10-15 years ago the VA was not cleaning their biopsy equipment and a lot of people, including my dad, got false positives for prostate cancer. I will never get a biopsy on my prostate.
Had a shootin’ match this morning. Seven shooters. 40 rounds plus sighters, each. 22LR. Felt just like fueling up a yacht with 7000 gallons of fuel.
That recipe might be fine for wound irrigation and so forth, but I would not want to use it for IV or sub-Q indications. It isn’t pH buffered, and probably not sterile (15 minutes of boiling will not kill spore forming bacteria, and pouring it in your kitchen has a high chance of contaminating it). I also doubt that most patients are trained in sterile technique.
I would suggest keeping the prepared containers in the dark in a cool place. I don’t necessarily recommend putting them in the fridge, since the fridge would inhibit (most) bacterial growth, but not fungal growth, and most home fridges are not routinely disinfected.
FYI, there have been various prescription drug shortages for (IIRC) a few years now. It looks to me like the shortages are expanding to include more common items now.
Don’t we just love when government steps into the business of trying to control supply and demand? < /sarc >
All good points. I did question if it could be used IV, but was posting quickly before we left for the evening.
It just is incomprehensible that we do not have domestic producers (plural) of something so commonly used.
Wasn’t a 100% serious, but coconut water I think was used also in Vietnam in a pinch. Below is excerpt about its use:
Coconut water can be used for a variety of medical purposes, one of which is intravenous re-hydration. A 2000 report tells of a stroke patient in the Solomon Islands who was too ill to drink or use a nasal tube but was successfully re-hydrated with a coconut-water IV when no other fluids were available. Emergency coconut IVs were reportedly used by the British and Japanese during World War II, and they’ve been clinically tested on humans several times to see how well they’d be tolerated. Answer: overall, pretty well.
Coconut water is an isotonic solution (very important) and could be used in emergency in the field when away from other sources of iv fluid.
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