Saline IV bags have been totally depleted in hospital wards across the country

Stores of IV drip bags have been almost completely depleted in hospitals around the country this week as hospitals move to ‘disaster’ footing.

A pregnant woman in s hospital delivery room with an IV drip. Picture: istock

Health Minister Mark Butler has launched an emergency response with states and top doctors to help the nation get through a worldwide supply crunch of IV drip bags, as doctors are forced to ­severely ration intravenous fluid for critically ill patients, postpone inductions of labour, and deliver medications by alternative injection methods.

Labor has convened a Response Group led by Victoria, amid a global shortage believed to be partly caused by US military stockpiling as fears of a conflict between Israel, Iran and its proxies, the terror groups Hezbollah and Hamas, escalate.

Stores of IV drip bags have been almost completely depleted in hospitals around the country this week as the IV fluid supply hits crisis levels and surgeons around the country are forced to cancel surgeries. Some maternity units are down to just one bag of the lifesaving medical item and doctors are forced to scramble to secure half-used bags from ambulances and postpone induced births for overdue babies.

Emergency wards, anaesthesia, resuscitation units, maternity services, and cardiac surgery are the hardest hit as hospitals issue urgent safety alerts and warn of critical risk to patients, with hospital administrators or regulators unable to say when supply will return.

The IV fluids are fundamental to many aspects of healthcare and are critical in the management of blood loss and severe wounds, the care of birthing mothers and preterm babies, and in accidents, heart attacks, severe gastroenteritis and in intensive care.

“Supply of intravenous fluids remains disrupted without clear time frames when supply will normalise,” said an urgent update from NSW Health to doctors and nurses. “This poses a significant risk to our ability to … safely deliver high quality patient care.”

In NSW, the Clinical Excellence Commission has taken charge of the crisis under its Disaster Framework. It is being described as just as significant a threat to hospital operations as the Covid-19 pandemic.

Mr Butler said the response group – which includes representatives from the primary care sector represented by the Australian Medical Association, private hospitals and top doctors – would ensure that “while shortages remain an issue, data is being shared, there is appropriate distribution and (we) are seeking additional procurement opportunities”.

Leukaemia sufferer Ross Dean holding intravenous drip bag stand.

Doctors across all hospitals are being asked to ration IV fluids, to “use the smallest volume of IV fluid appropriate”, limit IV fluid administration in day surgery, minimise fasting in surgical patients to reduce the need for fluid replacement, give medicines by alternative methods, and reduce the use of vascular devices as the supply crisis deepens.

Canberra Health Services issued a strategy for conserving intravenous fluids, including that “each new bag hung needs clear justification” to “avoid the use of more than one bag of fluid for surgery” where clinically appropriate, and to use the “sip until send” strategy ahead of surgery.

Mothers whose pregnancies have reached 42 weeks, after which the risk of neonatal death increases, are having inductions of labour postponed and being forced to undergo extensive monitoring of their babies in utero as obstetricians are forced to delay overdue births due to the crisis. Maternity units are managing potential critical risk to mothers in the event of haemorrhage, with some wards having almost completely run out of IV stock.

One major metro hospital was down to just one bag of IV fluid and eight bags in emergency stocks on Thursday night.

The global shortage has caused smaller offshore suppliers to Australia to prioritise their stockpiles locally. Australia’s only local and biggest manufacturer Baxter is working to keep up with increased demand, which has been exacerbated by a significant increase in hospital admissions for elective surgeries.

A spokesperson for Baxter said its manufacturing plant was “operating at historical volumes and full capacity to help meet the rising demand for intravenous (IV) and irrigation products, and we continue to invest in additional capacity expansion efforts”.

Glucose 5 per cent bags, Hartmann’s solution bags, sodium chloride 0.9 per cent bags, and water for injection bags are the main products affected.

Health authorities in mid-July were planning to manage the supply crisis over a two to three week period, but the situation has not stabilised and they are now facing an emergency situation across scores of hospitals, with plans drawn up for the potential mass cancellation of elective surgeries.

The IV fluids are made under highly specialised manufacturing conditions using purified, sterile water with sterile electrolyte components. They are critical in supporting kidney function in patients who are dehydrated and keeping the blood pressure up of patients in cases of sepsis as well as in managing blood loss.