A critical shortage of dextrose solutions in prefilled syringes and IV fluid bags is currently forcing emergency medical services (EMS) to adapt their protocols.
The Food and Drug Administration is currently reporting shortages of dextrose in 5%, 10%, 25% and 50% solutions. Manufacturing capacity to support these dextrose products is not expected to improve for some time. There is potential for shortages of these products to worsen if anything else disrupts the supply.
Dextrose solutions are a staple in the EMS drug box and are commonly used to treat hypoglycemia. Dextrose administration can restore blood sugar levels quickly.
Glucagon as an alternative
Glucagon administered as an intramuscular injection was historically used in EMS for hypoglycemic patients, although it is expensive and more difficult to administer than dextrose. Most EMS agencies no longer have this medication in their protocols. Nevertheless, during this critical dextrose shortage, glucagon could be a viable alternative to treat hypoglycemia. However, glucagon is also currently in short supply.
Other medication shortages
Many other important rescue medications are also in short supply, resulting in an ongoing challenge for EMS. An ideal emergency medical system has a secure supply of emergency medicines to ensure their availability and affordability. However, until such a system is achieved, EMS agencies are forced to adapt and use what is available to them.
Addressing shortages
Some things that EMS agencies can do to address shortages are:
- Adapt protocols to allow use of alternative drugs or formulations.
- Proactively manage stock.
- Evaluate and make improvements to logistics and EMS management.
