IV Infusion Bag Shortage Prompts Oral Hydration Protocol

Not only are small volume infusion bags of common fluids in short supply, large volume bags containing 500 mL or a liter of fluid now are in short supply. To address this shortage, many healthcare facilities are now rationing IV fluids and prioritizing their use.

Staff in the emergency department at Brigham and Women’s Hospital in Boston developed an oral rehydration protocol for people with mild dehydration. Their protocol involves first addressing the causes of dehydration, such as pain or nausea, and ensuring that the dehydration is mild (people with significant dehydration generally require IV hydration). The protocol outlines step-wise progression of drinking small amounts of flavored electrolyte solution, dilute sports drinks, or juice at prescribed intervals and tracking fluid intake. Staff suggest using a smart phone to set reminders.

Oral rehydration has fewer complications and costs less than IV therapy. People treated with this protocol were able to continue oral rehydration at home, and there was a significant reduction in IV fluid use. Although the protocol was used with patients with mild dehydration of any cause, there is applicability to oncology since some patients treated for cancer experience side effects, such as chemotherapy-induced nausea or oral mucositis, which can lead to dehydration. Oral rehydration may be an option.