A MARTÍNEZ, HOST:
As Hurricane Helene swept through western North Carolina, it flooded a factory that produces IV fluids used by hospitals all across the country. That means hospitals could soon face shortages. Sydney Lupkin is NPR's pharmaceuticals correspondent. Sydney, what happened at that factory?
SYDNEY LUPKIN, BYLINE: So that factory is in Marion, N.C., about 35 miles east of Asheville, and it was evacuated right before the worst of the storm passed. That's according to social media posts from employees. It's now shut down and is covered in mud, like a lot of the area. The facility is owned by Baxter International, and it's the company's biggest plant. It makes IV fluids - sterile water, saline fluids mixed with some carbohydrates.
MARTÍNEZ: Yeah. That's those bags that hang on poles next to hospital beds. But, I mean, aren't those bags everywhere?
LUPKIN: Yeah. They really are. They're used all the time in hospitals and surgery centers, not to mention dialysis centers. Here's Dr. Alison Haddock, president of the American College of Emergency Physicians.
ALISON HADDOCK: It is the rare patient in the emergency department that doesn't end up with some IV fluids in the course of their evaluation and treatment, sort of regardless of their chief complaint.
LUPKIN: Some drugs have to be given with IV fluid. Sometimes, emergency room patients can't have anything by mouth while they're being evaluated, just in case they need surgery, so they'll get an IV to stay hydrated.
MARTÍNEZ: All right. Now, with that factory shut down then, what does that mean for the supply of those IV fluids?
LUPKIN: So the Food and Drug Administration says this was one of the largest suppliers of IV fluids in the country, and it's working with Baxter and other parts of the government to get a handle on the situation. Baxter is limiting orders to prevent panic buying that could make things worse and to make sure that the existing supply of IV solutions is distributed evenly. One hospital executive told me he was only allowed to order 40% of his usual IV supply. Baxter also sent a letter to hospitals suggesting they reevaluate their IV fluids protocols to make sure they're going to the people who really need them and not being wasted. The FDA says it may look at temporarily allowing imported IV fluids to avoid shortages.
MARTÍNEZ: I don't understand. I would figure hospitals would have stockpiles of this stuff.
LUPKIN: Yeah. You would, but not as much as you might think. Unlike pills or vials of medicine, bags of IV fluids are really bulky. Each liter bag weighs more than 2 pounds. Here's Michael Ganio of the American Society of Health-System Pharmacists.
MICHAEL GANIO: They are large, and so hospitals, if they're managing inventory on-site, there's only so much they can keep on hand at a time, and it may be a week to 10 days' worth, depending on which specific solution we're referring to.
LUPKIN: He says hospitals are already digging up old policies from a few years ago when Hurricane Maria crippled a factory making similar products in 2017. You know, for better or worse, hospital pharmacists have been through this before.
MARTÍNEZ: Then, OK, patients at hospitals and also patients at dialysis centers, I mean, how might they be affected?
LUPKIN: An example I've heard a few times is that an ER patient might be given an anti-nausea medication and asked to try to drink Gatorade or Pedialyte to hydrate rather than getting an IV. That could save some of these products for patients in the ICU and patients who are getting surgery. Most of the juggling, however, will happen behind the scenes. Patients probably won't even realize anything is different unless things get really dire. The hope is that the FDA and health care system can prevent that from happening.
MARTÍNEZ: All right. NPR's pharmaceuticals correspondent Sydney Lupkin, thanks a lot.
LUPKIN: You bet.
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