IV Solutions Supply Chain Disruptions

Prepare a plan to mitigate disruptions to patient care.

Updated October 23, 2024

The Society of Critical Care Medicine (SCCM) is urging all hospitals and institutions to assess protocols related to fluid management to prepare for expected shortages.

A North Carolina facility manufacturing IV solutions for Baxter International was flooded by rains from Hurricane Helene, damaging supplies, raw materials, and local infrastructure required to access the facility. As a result, production has stopped until the situation is resolved. Baxter is working to assess the plant and determine what will be needed to bring it back into service.

Key Messages:

Be proactive about fluid management and assessment strategies.
There is no timeline yet for when the supply chain will be stabilized. Prepare for long-term disruption.
Communicate hospital-wide with other teams and leadership to develop short- and long-term strategies.

Hospitals are encouraged to implement or create a plan for limited IV solutions for the foreseeable future. Suggestions for management and conservation include careful assessment of clinical needs, assessing fluid responsiveness, discontinuing infusions as soon as appropriate, identifying alternative sources of solutions, optimizing oral fluid management, engaging multidisciplinary clinical teams, and maintaining clear communication with status and action plan adjustments.

Allocation Updates From Baxter

Baxter has been working to manage inventory and minimize disruptions to patient care, which includes implementing allocations that limit orders. Baxter continues to ramp up production across their global manufacturing network.

Check here for regular updates from Baxter.
Clinical Resources on IV Conservation

Baxter customers can call + 1 800 933-0303, option 1, during normal business hours for clinical questions regarding conservation strategies.

FDA Drug Shortage Updates

The FDA is working to temporarily import some products in shortage to help meet patient needs. Review this webpage on Baxter's manufacturing recovery in North Carolina for the latest information from the FDA.

SCCM Urging Federal Action

In response to the supply chain disruptions of IV and other medical solutions caused by Hurricane Helene, SCCM has partnered with 10 other healthcare organizations to send a letter to the FDA to urge federal action to help mitigate these issues. Read More

Key Resources for IV Fluid Shortages

Small- and Large-Volume Fluid Shortages ‒ Suggestions for Management and Conservation (ASHP)
ATS Clinical Recommendations: 10 Steps for Hospitals Facing Intravenous Fluid Shortages (Compiled in response to Hurricane Maria)
SCCM Webcast: IV Fluid Management During Shortages
SCCM Tip Sheet: Strategies for IV Fluid Conservation in the ICU

Additional Resources

EDSA IV Fluid Conservation Webinar (10-9-24)

SCCM Resources

Fluid Stewardship Resources

Resources to Help During Drug Shortages

Fluid Assessment Resources

Share Your Knowledge

Do you have microlearning content on managing shortages or about fluid management and stewardship that may be helpful to others? Submit it to the Critical Care Quick Study through MySCCM.

The Critical Care Quick Study is an open-access repository for microlearning content designed to accommodate modern learning habits.

Please share any resources or strategies, especially if you are in a unique or resource-limited setting. Education on hospital implementation strategies, ultrasound, passive leg raising, and patient evaluations to carefully make decisions about choice and amount of fluids may be useful to clinicians and hospitals experiencing shortages.

Submit Now

Discuss Solutions on SCCM Connect

SCCM members have begun a thread on SCCM Connect to share tips on mitigating disruptions and to discuss the impact that these shortages may have on hospitals and patient care.

Join the Conversation