By Kate Aubusson and Angus Thomson
A worldwide shortage of intravenous fluids is leading to severe rationing in NSW hospitals, with doctors asked to avoid putting some patients on a drip and specialists warning they may be forced to cancel some non-urgent surgeries.
NSW Health sent out an internal safety alert to hospital medical staff this week warning there would be an extreme risk of intravenous fluid (IV) supply shortages over the next two to three weeks “due to shipment delays”.
Intravenous fluids are crucial for both routine and emergency care, used in almost all surgeries and to administer medication directly into the bloodstream.Credit: Getty Images
The Clinical Excellence Commission, NSW Health’s lead safety agency, is now co-ordinating the state’s supply of IV products under its disaster framework.
Products affected are Glucose 5 per cent bags, Hartmann’s solution bags, sodium chloride 0.9 per cent bags and water for injection bags in all volumes, according to the alert.
An internal memo sent to staff at St Vincent’s public hospital asked that they consider delivering medicine through other methods and also consider “fluid replacement via the oral route of administration if appropriate”.
At Westmead Private, IV fluids can no longer be used for simple scopes and minor procedures to conserve the hospital’s limited supply.
Sydney Adventist Hospital also asked staff to conserve supplies to ensure the shortage did not limit admissions or impact patient safety.
IV fluids are essential for both routine and critical hospital care. They are used in almost all surgeries and to administer medication directly into the bloodstream.
Anaesthetists, who oversee hospital surgery lists, may need to cancel non-urgent elective surgeries if the extreme rationing measures don’t preserve enough IV fluid needed for the procedures.
Katherine Jeffrey, a Sydney-based anaesthetist and Australian Medical Association (AMA) representative, said she had already been limited to one-litre of fluid in a six-hour procedure.
She said a patient fasting for surgery was “like a car running on a near-empty tank”, and IV fluids were the simplest way to deliver power to the fasting body and prevent complications such as heart or kidney injury.
“I am worried because I cannot do my normal practice,” she said. “If I don’t get enough fluids in the right patient, they’re not going to wake up well.”
AMA NSW Vice President Fred Betros, a general surgeon in western Sydney, said the restrictions were not to the levels seen during the COVID-19 pandemic, but hospitals had “enacted dramatic changes” to allow elective surgeries to continue.
“We have been told to restrict IV fluids unless they are absolutely necessary,” he said. “My concern is that if we don’t have enough IV fluids we risk having to cancel non-urgent elective surgery.”
A NSW Health spokesperson said the department was taking all available steps to minimise potential disruptions to patients and services.
“To date, no elective surgeries in NSW public hospitals have been cancelled as a result of the IV shortages,” they said.
Health Minister Ryan Park said he was receiving regular updates on the response and the state government was working constructively with federal colleagues.
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