Across the nation health systems and physician practices are reeling amid an IV fluid shortage after Hurricane Helene damaged a Baxter International plant in North Carolina. Spine surgeons discuss how they are strategizing amid the ripple effects.
Note: Responses were lightly edited for clarity.
Question: How have recent IV shortages affected your practice? Have you made any adjustments to your day-to-day life in response?
Brian Fiani, DO. Spine surgeon. (Birmingham, Mich.): Recent IV shortages have significantly affected many spine surgery practices by leading to delays in procedures, increased reliance on alternative medications, and the need for careful inventory management. Many practices have had to prioritize surgeries based on urgency and availability of necessary supplies. Additionally, some facilities are exploring or implementing protocol adjustments, such as using different sedation or analgesia methods when standard IV medications are unavailable.
Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: As of this writing, we have not started canceling any forthcoming operations. Some of my urology colleagues have been told to cancel their elective cases. I imagine if the manufacturing facilities are not brought back online, we will see others as well. I am the most concerned about safety net and level I trauma centers that simply cannot afford to stop doing what they need to do to serve their communities.
Vladimir Sinkov, MD. Sinkov Spine. (Las Vegas): The hospitals in my area have instituted measures to conserve IV fluids in response to this shortage. Personally, I have already instituted measures in my surgical practice to minimize IV fluid usage — minimally invasive surgery leads to less blood loss and less pain. Therefore the patients do not require as much IV fluids during the surgery or postoperatively to restore volume loss. In addition, the patients who underwent minimally invasive spine surgery have less pain, therefore they require less pain medications, have less nausea and are able to transition to oral fluids quicker.
Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Our anesthesiology corps were quite aware of the national shortages and the possible repercussions. Fortunately, there is a stockpile locally and minimal adjustments have been made. One adjustment is heparin lock placement instead of a routine IV setup for selective patients in the ER, labor and delivery and minor surgery cases as a measure to conserve supplies.
After Hurricane Helene swamped the Baxter International's North Cove Manufacturing in Marion, N.C., the IV fluid shortages have been substantial especially in the eastern seaboard. We have been informed by colleagues that elective surgical practices in many larger metropolitan areas have been curtailed until critical supplies are more reliable. The FDA has authorized temporary importation from Baxter plants in Canada, China, Ireland and the U.K. Baxter is working with the FDA to authorize imports from its other international sites as well.