Normally, hospitals are flushed with IV fluids. But at the moment that is not the case. In addition to physical damage to many hospitals and clinics in the region, Hurricane Helene shut down one of the major manufacturing plants for IV solutions. Baxter’s manufacturing plant in Marion, NC, which produces approximately 60% of IV solutions for the US, is currently not operational.
With Hurricane Milton likely to place additional stress on healthcare systems in Florida and other affected states, hospital leaders have called on the Biden administration to declare a national emergency surrounding IV fluids.
As a primary care physician in Nevada, I have already received reports from our local hospitals about a looming shortage of IV fluids. My wife, an anesthesiologist, is working with her group and hospital on strategies to keep operating rooms functioning while they have to make do with about 40% of their standard shipments. This shortage will impact many of my patients who have elective surgeries or require IV fluids for their cancer chemotherapy. I’m planning to have elective neck surgery in November or December, and I’m not sure if my local hospital will have enough IVs for elective surgeries then.
While some hospitals are considering some creative ideas To conserve their supplies for patients who need them most, there is one simple solution to start conserving IV fluids. Elective IV hydration bars and spas should suspend operations until the shortage subsides.
Although the concept of intravenous hydration as a ‘health benefit’ dates back to the 1960s, IV hydration bars started taking off about 10-15 years ago. One of the first companies operated out of a bus in Las Vegas, providing intravenous hydration for hungover visitors. Since then, IV bars have popped up across the country, touting many dubious health benefits for patients willing to pay a few hundred dollars. These spas typically include a menu of various vitamins and supplements that are sold to people under the guise of a “natural way” to become healthier. Some expensive residential buildings even offer it as a provision.
A popular target of these IV spas and mobile treatments are athletes. As medical director of the Western States Endurance Race and the Tahoe Rim Trail Endurance Race, I have worked to educate our athletes about the damage and lack of benefits from IV fluids for athletes. The American College of Sports Medicine specifically states“IV fluids provide no benefit over drinking oral fluids and electrolytes.” The U.S. Anti-Doping Agency and the World Anti-Doping Agency ban routine IV fluids because they can mask drug testing. During my time in endurance events, we have made great strides in limiting IV fluids to runners who are critically ill and have undergone proper laboratory testing, which is rarely done in IV spas.
A second market for IV hydration spas is people who plan to drink too much alcohol or have had too much to drink the night before. When I last walked through Las Vegas, it seemed like every casino on the strip now has at least one hydration spa on site. Many spas offer group packages for bachelor and bachelorette parties. Alcohol abuse is a major public health problem in our country. Medical professionals who spend their resources on relieving people of a time-limited, self-imposed condition would be better deployed elsewhere. During this IV emergency, it’s honestly a waste to help someone feel better after their hangover, while seriously ill patients may experience delays in care.
When I talk to some of the people who work at these spas, I often hear anecdotal stories about the health benefits of IV hydration for some of their clients. Although there may be some isolated medical conditions in which patients may benefit from IV hydration, patients with these conditions may best have the IVs done in an outpatient setting with laboratory access. If patients need IVs, they must get them from general practitioners or specialists who have no financial incentive to inject the fluids.
Similar to our recent shortages of critical medications, we may soon reach a critical point where our nationwide shortage of IV fluids will impact essential surgeries and life-saving treatments. The number of IV rods may not be huge – only 500 are estimated one estimate that actually seems very low to me – compared to the number of medical centers that need the fluids. But every drop counts at a time like this. And anyone who gets a recreational infusion is taking it from a patient. The first step to safeguarding our offering for patients with critical medical conditions would be to direct the IV fluids used in these spas to patients who really need them.
Dr. Andrew Pasternak is a family physician at the Silver Sage Center for Family Medicine in Reno, NV. He is a past president of the Nevada State Medical Association and medical director of Western States 100.