People rushing to the emergency department seeking treatment for two common illnesses may not receive the treatment they need.
A new analysis shows patients with dehydration or nausea are half as likely to get treated with intravenous fluids due to a supply shortage caused by Hurricane Helene’s devastation.
When the Category 4 storm hit North Carolina in September, it damaged Baxter International’s manufacturing facility, a company which supplies 60 percent of the nation’s intravenous solutions.
These life-saving fluids contain water, electrolytes and sometimes sugar, and are used to rehydrate patients, manage blood pressure and to keep someone stable during surgery, minor procedures or in outpatient care.
Health authorities warned disruption to Baxter’s facilities would require a nationwide rationing of IV fluids. The CDC recommended that when possible, hospitals should use other means of re-hydrating patients, like giving them Gatorade.
The shortage of fluids, and resulting rationing, interrupted dialysis appointments, surgeries and people coming into the ER for a host of problems, including dehydration.
The new data only goes to mid-October, but the researchers suggest the effects of the shortage will continue to reverberate through the healthcare system for months to come.
Though they are common – and typically mild symptoms – if left untreated, severe dehydration and vomiting can cause serious health problems.
This graph from the analysis shows the rate of IV treatments given to people who were admitted into the emergency department for dehydration starting in January of 2024, ending weeks after Hurricane Helene
This graph from the analysis shows the rate of IV treatments given to people who were admitted into the emergency department for nausea or vomiting starting in January of 2024, ending weeks after Hurricane Helene
This includes, dizziness, muscle cramps, constipation, electrolyte imbalance, shock, coma, kidney failure and death.
When a person loses electrolytes from dehydration, they can become fatigued, confused and may experience cramping, convulsions and irregular heartbeat.
Getting crucial minerals back into their body quickly via IV fluids can help stabilize them faster than if they were drink the fluids.
While using an electrolyte-heavy sports beverage can be helpful in rehydrating, it’s not as efficient as using an IV to rehydrate someone. This is because the fluid is able to enter the blood stream directly, without delaying through the digestive system.
Truveta Research, a company that collects and analyzes health records from 30 health systems across the US, performed the analysis, which has yet to be peer reviewed.
It gathered records from 345,746 emergency department (ED) visits for people over age 12 who were admitted for nausea, vomiting or dehydration from January to mid-October 2024.
Before the hurricane hit, about 5.5 percent of patients who came to the ED with nausea or vomiting were treated with IV fluids. Ten days after the hurricane, that dropped to two percent.
Similarly, before Helene, 6.6 percent of patients in the ED with dehydration were given IV fluids, compared to 2.5 percent of that same group 10 days after the hurricane.
The study authors predict the effects of this shortage will continue to be felt for the rest of the year. They said: ‘The saline shortage is expected to continue. We anticipate this to lead to even further decreases in the rates shown here.’
Intravenous fluids are used in operating rooms, outpatient clinics and home healthcare to administer medications and rehydrate patients
This week, the FDA announced it approved extending the shelf life of IV fluids and other fluids made by Baxter, making more older products available for use.
They also have supported importing more IV fluids from other countries and ramping up production at other US IV fluid manufacturers.
Dr Chris DeRienzo, chief physician executive with the American Hospital Association told CNN: ‘These conservation efforts are making a big difference in helping ensure that for patients who really have no alternative, we’ve got the supply that we need.
‘Every patch that we put on this patchwork quilt to try to cover that 60 percent hole is helpful.’
At the same time, Baxter is working on getting its facilities back online.
When flood waters hit North Carolina, they washed out bridges to the facility and flooded the factory. Baxter announced that a temporary bridge has been constructed to allow for clean up, and said on October 31st some manufacturing had already restarted.
Xavieras Baecerra, the Department of Health and Human Services Secretary, said that re-establishing operations at Baxter’s North Carolina plant, even in partial capacity, is ‘encouraging’.
Baecerra said: ‘The output from the restarted line, which will be closely monitored to help ensure the quality and safety of released product, will supplement product that is being imported from abroad in accordance with temporary grants of regulatory flexibility from FDA’.
Attacking this shortage from multiple angles is crucial because of how frequently IV fluids are used in medicine.
This situation not only affects those people coming in for emergency treatment, but also interrupts every day procedures and surgeries.
Baxter’s facilities were cut off from the outside world when flooding from the hurricane swept out bridges to their grounds. Latest reports say a temporary bridge has been constructed, allowing clean up crew to enter the premises
Hospitals like the The University of Virginia Health’s Medical Center, cancelled some surgeries in the weeks after Helene over concerns that they wouldn’t be able to keep a patient stable during an operation without adequate IV fluids.
Dr Tricia Pendergast, an anesthesiologist, explained that these supplies are necessary to support successful surgeries.
Dr Pendergast said on TikTok: ‘If you’re in healthcare, I do not need to explain to you how devastating an IV fluid shortage is. I personally used five or six of them in the operating rooms today.’
This also interrupts life-saving at-home and outpatient treatments, like dialysis.
Dialysis is a treatment that filters someone’s blood when their kidneys aren’t working properly, and patients sometimes need it multiple times a week to stay alive, for years at a time.
Dialysis companies, like DaVita Kidney Care, rely on IV fluids to run their machines. Davita reportedly sent a letter to it’s employees, warning that Baxter’s North Carolina plant is the primary supplier of dialysis solutions.
Without these fluids, people have to postpone treatment, with potentially life-threatening affects. The company has 2,600 outpatient clinics in the US serving 200,800 patients in kidney failure.
A woman said on X: ‘My husband is on peritoneal dialysis and was scheduled to have fluids delivered today. Baxter canceled. He has two weeks’ worth left. Why on Earth would there not be a backup plan?’
