ASHP Fact Sheet: Small- and Large-Volume Fluid Shortages

ASHP and the University of Utah have issued a fact sheet for small- and large-volume fluid shortages.

The sheet said, “This fact sheet provides potential actions for organizations to consider in managing fluid shortages. Healthcare practitioners should use their professional judgment in deciding how to use the information in this document, considering the needs and resources of their individual organizations.”

Further, the sheet says conversation is necessary because there is a national shortage of large-volume parenteral solutions, including but not limited to: sodium chloride injections, Lactated Ringers injection, Sterile Water for Injection, and Dextrose injections.

We’ve been covering the shortages.

The sheet added, “Small-volume parenteral solutions (SVPs) — a solution volume of 100 mL (as defined by USP) or less that is intended for intermittent intravenous administration (usually defined as an infusion time not lasting longer than 6-8 hours).”

Further, “Large-volume parenteral solutions (LVPs) – a solution volume of greater than 100 mL (as defined by USP).

“Intravenous (IV) push — The Institute for Safe Medication Practices (ISMP) defines IV push as “direct, manual administration of a medication using a syringe, usually under pressure, connected to an IV access device.”2 Best practice recommends that whenever possible the actual rate of IV push administration specific to a given drug be noted and that terms such as IV push (unspecified), IV bolus (unspecified), slow or fast/rapid IV push should be avoided.

“Ready-to-administer — A dosage form or concentration that can be administered to the patient without further manipulation.”

The fact sheet also stated that general recommendations include implementing an organization-specific action plan, ensuring an interdisciplinary team is making rationing decisions using an ethical framework, communicating changes in shortage status and action plan adjustments to stakeholders, and identifying vulnerable and populations with specific needs.