By Julie Cullen, Managing Editor, American Nurse Today
To address the I.V. fluid shortage that’s been affecting U.S. hospitals since 2014—and was worsened after Hurricane Maria hit in Puerto Rico in 2017—some hospitals are developing protocols to reduce their use of I.V. fluids.
An article in the March 21 issue of the New England Journal of Medicine calls out an oral rehydration program created by the Division of International Emergency Medicine and Humanitarian Programs of the Department of Emergency Medicine at Brigham and Women’s Hospital in Boston. The program targets patients in the ED who are mildly dehydrated, such as those with acute gastroenteritis, pregnancy-related hyperemesis, and mild viral upper respiratory infection or pharyngitis. Patients with moderate to severe dehydration or those who can’t receive oral intake are excluded. Through the electronic health record, the provider orders 500 mL of oral rehydration fluids (the patient can choose a flavored oral electrolyte solution, diluted sports drink, or juice). The patient is then given specific instructions about how to consume the fluids (two large sips ever 3 to 5 minutes) along with target hydration goals.
The I.V. fluid shortage is expected to continue, so hospitals across the country may want to replicate this research-based protocol.
Source: New England Journal of Medicine; nejm.org/doi/full/10.1056/NEJMp1801772?query=TOC&