ACR Guidance on Potential Shortage of IV Products/Saline Bags

The American College of Radiology® (ACR®) strongly supports our members, colleagues, patients, and all those impacted by Hurricane Helene and the ongoing catastrophic weather events in the southeastern United States.

ACR is aware of practices that may be impacted by a shortage of IV products including saline bags because of the shutdown of a Baxter International plant in Marion, NC, that manufacturers more than half of such products available in the U.S. The plant went offline after suffering critical damage from Hurricane Helene.

While radiology may not be as highly impacted as other specialties, we are committed to doing our part to ensure optimal patient care through this time of potential shortage. The following are approaches that ACR members are taking to make the most efficient use of these IV solutions during this time. Local radiology practices are encouraged to adopt these or similar practices to conserve resources.

• Reduce test flush/patency flush to 20ml.
• Reduce or eliminate saline chasers used in computed tomography (CT):
• For all venous phase studies, use 10 ml saline chaser instead of 30 to 50 ml.
• For CTAs and liver/pancreas protocols, use 30 mL chaser instead of 50 ml.
• Venograms remain unchanged; GU protocols like IVP's still use standard protocol of 200 mL.
• Reduce (but not eliminate) chasers for MR to 10ml (if possible).
• Hospital wide policies that also apply to radiology:
• Once a bag is spiked, try to use the whole thing. Use the smallest bag you think you might need.
• Continue to be cautious when spiking the saline to avoid puncturing the side of the tubing as that would waste the entire bag.

Other organizations - including the American College of Emergency Physicians (ACEP) and the American Society of Health-System Pharmacists (ASHP) - issued similar guidance that may be helpful.

ACR will continue monitoring the situation and will share additional guidance as it becomes available.

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