Practice Consideration

IV Fluid Shortage Management (Practice Consideration)

Last AANA revision: 2024

Frequent national IV fluid shortages (LR, NS, D5W) require contingency planning. Strategies: alternative fluid selection, conservative fluid administration, oral hydration when feasible, prioritization protocols.

Key points

1.Substitution hierarchy: balanced solutions (LR, Plasma-Lyte) > NS (chloride load concerns)
2.Conservative fluid: goal-directed therapy, restrictive intra-op (esp. lap surgery), permissive hypotension trauma
3.Oral hydration: clear liquids up to 2h pre-op (ASA), reduces IV need post-op
4.Bolus prioritization: hemorrhage > sepsis > maintenance
5.Communicate plan to surgical team + nursing during shortages

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