Saturday, January 25, 2014

American Health Care 2014...a shortage of WHAT?!

Continuing for a few days my musings on the current state of the US health care system...

I arrived in the ER for my Friday shift only to be met with a note announcing that there was a nationwide shortage of "normal saline".

WTH!!!!!

Normal saline for those not in the trade, is a commonly used IV fluid. Very handy stuff if you need to quickly re-hydrate somebody or as initial fluid resuscitation in trauma.  It is made of:

Water.

Salt.

That's it.  Not exactly a complex, hard to manufacture, 21st Century Wonder Drug.

It seems that we are not short of water.  And we have plenty of plain old NaCl.  Apparently the problem is that a large number of bags of the stuff were found to have dubious plastic connectors, making it difficult to be sure that the stuff is actually sterile.

Primitive technology.  But still lifesaving stuff.  And unavailable because somebody (I figure in some third world manufacturing system) did not pay attention to some stupid but critical step in manufacturing a bazillion little plastic do dads to be shipped off to the United States.

We can still administer IV fluids of course, but have been reduced to using an alternative IV juice called Lactated Ringers.  Nobody likes it except surgeons.  They love the stuff, which is sufficient reason in my book to be suspicious of it.

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