‘They’re asking you to be a gatekeeper’: Doctors still forced to conserve intravenous fluids despite 22 million bags ordered

Doctors continue to hear recommendations to conserve and control intravenous fluids even as the federal government has secured millions of additional bags and said there have been “no recent reports” of any shortages.

As the government seeks to reassure Australians there will be “more than enough” intravenous fluids in the coming months to meet demand, a senior doctor at a major Sydney hospital has described the situation as “complete sh**”.

The government said it had managed to secure an additional 22 million bags amid growing pressure to increase supplies of essential medicines.

However, the ABC later confirmed the 22 million figure was the total number of deliveries expected over the six months, including about 19 million bags Australia would typically receive in the same period.

The government says supply will exceed expected demand.

Australia is facing a global shortage of intravenous fluids such as saline and sodium lactate solution, essential medicines used across the sector, from treating dehydration to helping patients in intensive care units and post-operative care.

Last month, the ABC revealed that patients were having to stay in hospital wards for longer after procedures because doctors were rationing intravenous fluids due to shortages.

A senior Sydney doctor spoke to the ABC on condition of anonymity because he is not authorised to speak publicly.

They said they were frustrated that the environmental policies were still in place two months after the Therapeutic Goods Administration (TGA) first revealed the shortages.

“You are expected to act as a gatekeeper, deciding who gets these crucial fluids and who does not,” they said.

Intravenous fluids will likely need to be stored until the end of the year

A national response group coordinating efforts from states, territories and health experts meets regularly to address shortages.

A statement from the meeting on Monday, seen by ABC, said the situation remained “stable” but noted that there could be supply constraints until the end of the year.

The statement said community care centres and day care centres were reporting “periodic shortages” which could impact how some services were delivered.

The response group also recommended that as the situation stabilizes, guidelines “continue to recommend prudent protection.”

Australian and New Zealand Academy of Anaesthesiology (ANZCA) president David Story, who is a member of the response group, said fluids would likely need to be stored until at least the end of October and possibly until the end of the year.

“We are giving patients, many patients, less fluids than we would like — particularly those who are undergoing day surgery, for whom it probably won’t significantly impact their prognosis, but it may worsen their well-being when they leave the hospital,” he said.

“Supply is increasing and I understand that our local manufacturer will be able to increase production soon, but we have not had a large influx of bags, so we still suggest limited practices at this time.”

‘Teething problems’ with IV fluid distribution: AMA

Australian Medical Association (AMA) president Steve Robson, who is also a member of the response group, stressed that the situation was improving.

However, he added that there were “teething problems” in ensuring the equal distribution of intravenous fluids across health districts.

“Because this is such a unique situation that has never happened in Australia before, it has taken some time to put mechanisms in place to deal with it,” he said.

“We know we have almost enough intravenous fluids to meet demand, but of course they need to be distributed and while that is happening, caution needs to be exercised.

“Right now, it looks like we’re all going to have to be careful not to waste intravenous fluids or use them unwisely, at least until the end of this year.”

He added that the situation exposed gaps in the supply chains of the Australian manufacturing sector.

“It really was a wake-up call that we can’t be complacent, and Australia really has been complacent for decades in terms of the supply of essential medical supplies.”

On Wednesday, Health Minister Mark Butler said additional bags had begun arriving in Australia.

“I haven’t received any recent reports of shortages in the last few weeks. Of course I’m watching this very closely,” he said.

“I am confident that we will alleviate the shortages that we have seen over the last few months.”

The national response group is scheduled to meet again later this month.