Saline shortage leaves hospitals scrambling for key medication ingredient

December 13, 2017 06:37 PM

There's a critical shortage of saline solution, the backbone of many medications. The problem stems from the devastation in Puerto Rico following Hurricane Maria. How are local hospitals managing this?

Puerto Rico is home to more than four-dozen, FDA-approved drug-manufacturing plants. The devastation brought by Hurricane Maria either shuttered the plants or severely curtailed their output. That created a crisis in the availability of saline solution.

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I reached out to Albany Medical Center to see how they're managing this crisis and keeping patients, safe.

"In the beginning, it was tough," admitted Anthony DiSpirito, Pharm D., the director of pharmacy at Albany Med.

Albany Med scrambled to insure patient care wouldn't suffer when Hurricane Maria ravaged drug manufacturing companies in Puerto Rico. Their key concern was getting saline solution, which is used to reconstitute a wide array of drugs.

"I'd say 75-percent of the drugs that we administer are diluted in some form of normal saline or dextrose," noted DiSpirito.

While these large bags of saline are available, the smaller, more dose specific bags are not. So Albany Med has been buying empty smaller bags and filling them.

"A lot more work for our people. The nursing staff has to adjust to seeing things. They don't normally see these bags, so things look a little bit different to them also," explained DiSpirito.

The bags the pharmacy staff is filling have a shorter shelf life than the pre-filled bags -- seven to nine days versus about a month.

"You try not to make too many at a time, overburden your staff and then have to waste these bags. Instead, we try to just keep up," noted DiSpirito.

When it first appeared that there would be a shortage, Albany Med stockpiled as much saline as it could get its hands on. It's a good thing they did, because the shortage could last until March.

Unfortunately, DiSpirito says Albany Med hasn't been able to help other hospitals in the area fill their shortages.

"Only this week, we were able to help out Malta Med Emergent Care, in that we shipped them six cases of these larger volume bags," pointed out DiSpirito.

In an emergent care setting, the larger bags are used for rehydration and blood pressure management. DiSpirito says patient care has not been interrupted and now that the FDA has fast-tracked approval of saline from other countries like Ireland and Australia, he's finally breathing a little easier.

Dr. DiSpirito says this is also costing the medical center a lot of extra money - both in employee hours and in materials.


Benita Zahn

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