Hospitals around the country are conserving critical intravenous fluid supplies to cope with a shortage that may last months. Some hospital administrators say they are changing how they think about IV fluid hydration altogether.
This story also ran on NPR. It can be republished for free.
Hurricane Helene, which hit North Carolina in September, wrecked a Baxter International facility that produces 60% of the IV fluids used in the U.S., according to the American Hospital Association.
The company was forced to stop production and is rationing its products. In an update posted Nov. 7, Baxter said its North Cove facility had resumed producing some IV fluids. In an email to KFF Health News, the company wrote that customers will be able to order normal quantities of certain IV solutions products by the end of the year, but there is no timeline for when the North Cove facility will be back to prehurricane production levels.
Meanwhile, hospitals are facing seasonal strains on their already limited IV fluid resources, said Sam Elgawly, chief of resource stewardship at Inova, a health system in the Washington, D.C., area.
Weve been very aggressive in our conservation measures, Elgawly said, stressing that he does not believe patient care has been compromised. He told KFF Health News that across the system IV fluid usage has dropped 55% since early October.
Elgawly called the shortage a crisis that he expects to have to continue managing for some time. We are going to operate under the assumption that this is going to be the way it is through the end of 2024 and have adopted our demand/conservation measures accordingly, he said. Email Sign-Up
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At the end of the calendar year, many patients with insurance hurry to schedule surgical procedures before their deductibles reset in January. Elgawly is eyeing that typical surgical rush and the impending peak of respiratory virus season as he tries to stockpile IV fluid bags. Hospitals such as Inovas are using different ways to conserve, such as giving some medications intravenously, but without a dedicated IV fluid bag, known as a push medication.
You don’t even need a bag at all. You just give the medication without the bag, he said. There has been increasing literature over the last 10 to 20 years that indicates maybe you don’t need to use as much. And this accelerated our sort of innovation and testing of that idea.
Monica Coleman is a nurse at a Department of Veterans Affairs hospital in North Chicago. She said using push medications takes more time out of a nurses already hectic schedule because then they need to monitor the patient.
This could increase adverse effects within the patient, because we’re giving the medication at a faster rate, she said.
Elgawly is also interested in retooling electronic health records to question doctor orders for more IV hydration.
Does the patient actually need that second bag? How did they do today with eating or drinking water or juice? They did well? They don’t need the bag. So it’s little conservation mechanisms like that that, when you add them across, you know, the 2,000-patient system that Inova is, make a significant dent, he said.
Simpler conservation measures could become common after the shortage abates, said Vince Green, chief medical officer for Pipeline Health, a small hospital system in the Los Angeles area that serves mainly people on Medicare and Medicaid.
First, Green would like to see data showing that patient outcomes arent affected. But for now, some of the new strategies just make sense to him. He has directed hospital staff to use up the entire IV bag before starting another.
If they come in with IV fluids that the paramedics have started, lets continue it. If it saves half a bag of fluids, so be it, but it adds up over time, he said.
Patients may be asked to take more accountability for their hydration, by drinking Gatorade or water rather than the default of hydrating through an IV, he said.
From an environmental aspect, we don’t need to have this much waste and fill up our landfills. If we could reduce stuff, I think it’d be wise, he said.
But hell feel better when his hospitals receive a full order, which could be weeks away. Green said they are down to a two-week supply, with an expected increase in hospitalizations due to respiratory virus season.
We’re purchasing every IV fluid bag that we can get, he said.
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Alibaba announced plans to release a pair of smart glasses powered by its AI models. The Quark AI Glasses are Alibaba’s first foray into the smart glasses product category.
Alibaba
Alibaba on Monday unveiled a pair of smart glasses powered by its artificial intelligence models, marking the Chinese firm’s first foray into the product category.
The e-commerce giant said the Quark AI Glasses will be launched in China by the end of 2025 with hardware powered by the firm’s Qwen large language model and its advanced AI assistant called Quark.
The Hangzhou, headquartered company is one of the leaders in China’s AI space, aggressively launching new models with capabilities that compete with Western counterparts like OpenAI.
Many tech companies see wearables, specifically glasses, as the next frontier in computing alongside the smartphone. Quark, which was updated this year, is currently available as an app in China. Alibaba is stepping into the hardware game as a way to distribute the app more widely.
The Quark AI Glasses are Alibaba’s answer to Meta’s smart glasses that were designed in collaboration with Ray-Ban. The Chinese tech giant will also now compete with Chinese consumer electronics player Xiaomi who this year released its own AI glasses.
Alibaba said its glasses will support hands-free calling, music streaming, real-time language translation, and meeting transcription. The glasses also feature a built-in camera.
Alibaba owns a range of different services in China from mapping to an online travel agent. Its affiliate company Ant Group also runs the widely-used Alipay mobile service. Alibaba said users will be able to use a navigation service via the glasses, pay with Alipay and compare prices on Taobao, its China e-commerce platform.
The firm has yet to release other details such as the price and technical specifications.
Tesla will use Samsung for as a supplier for its self-driving computer’s next-gen hardware in a $16.5 billion deal, according to Tesla CEO Elon Musk.
But despite planning two generations ahead, the company still doesn’t have a solution to bring the promised full autonomy to hardware that it’s been promising that capability to since 2016.
Earlier today, Samsung announced a 22.8 trillion won ($16.5 billion) deal that would run through 2033. In that filing, Samsung did not name the customer, only that it is a “large global company”. Later, Bloomberg reported that the customer is Tesla, and Musk confirmed this on twitter. Then in his usual bravado, he stated that the deal is “likely much more than that.”
Samsung makes the chips for the self-driving computers in Tesla’s current vehicles, but the next generation will be made by TSMC, first in Taiwan and then later in Arizona. Then the next-next generation will be covered by this new Samsung deal.
The new deal is significant due to TSMC’s global dominance of chipmaking. Samsung has had significant unused capacity, so the Tesla deal is a big boost for the company’s chip foundry business.
Tesla has gone through several generations of chips, previous referred to as “HW,” standing for “hardware,” with a number indicating their generation. More recently, Tesla started referring to its chips with “AI” instead of “HW,” in order to incorporate the tech buzzword du jour.
Currently Tesla is on HW4/AI4, and TSMC will make HW5, then Samsung will make HW6 again.
These generations of hardware each get successively more capable, and can handle more data and thus theoretically become better at self-driving tasks.
Current Tesla HW4 vehicles cannot drive themselves, and are only capable of SAE level 2 operation, which requires an attentive driver behind the steering wheel (though Tesla’s solution does work better than most others). Tesla’s ‘Robotaxi’ system is currently operating in Austin without anyone in the driver’s seat, but has a “safety rider” who can take control of the vehicle, blurring the line somewhat on which SAE level it is operating at.
But what about HW3?
There’s a problem with the differentiation between these generations of hardware: ever since 2016, when Tesla was on version 2 of its hardware, it has promised full self-driving capability on all of its vehicles.
Tesla stated, at the time, that every single Tesla vehicle produced after that date had the hardware that would allow for full self-driving.
It eventually became apparent that HW2 would not be capable of full self-driving tasks, and Tesla upgraded to HW3, promising all HW2 customers that they would get a free upgrade to HW3 if they bought Tesla’s Full Self-Driving system, which has varied in price over time but once cost $15,000.
Now, with the change from HW3 to HW4, we’re seeing indications of a similar run-around.
We’ve already seen differing FSD software versions based on which hardware level vehicles have, with HW3 vehicles getting updates later than HW4 vehicles do. On last week’s Q2 earnings call, Tesla CFO Vaibhav Taneja said:
What we want to do is get unsupervised done on hardware four first. Once it’s done, then we’ll go back and look at what we need to do with the hardware three cars. Like I said, the focus is first to get unsupervised out and then we’ll go back and see what more work we need to do.
“Unsupervised” is Tesla’s new name for actual full self-driving, which would allow a vehicle to drive without the supervision of someone in the driver’s seat. This as opposed to “supervised FSD,” a phrase Tesla started using after about a decade of promising full self-driving without delivering it.
Here, Taneja said that HW3 cars will eventually get FSD, but Tesla hasn’t really figured out the path to that, and it’s focusing on new cars first, then will go back around to see what needs to happen.
Previously, Musk had stated that Tesla “will have to upgrade people’s hardware 3 computer,” but more recently it has become apparent that Tesla really doesn’t have a plan for that upgrade. And Taneja’s comments suggest that Tesla will still try to wedge FSD onto HW3, despite previously admitting that the system is not capable of it.
The existence of future HW5 and even HW6 chips also suggest that current systems are not capable of full self-driving. If HW4 is FSD-capable, then why would Tesla need two more generations of chip in the next two years in order to do the tasks that it promised all of its cars could do a full decade prior?
So, much more than having no solution for HW3 cars (or even HW2 cars, some of which have gotten free upgrades, but others who have been charged $1,000 to upgrade to a computer they already paid for), does this mean that Tesla is going to kick the can further down the road, and eventually have no solution for HW4 and HW5 either?
And, when will we know about these solutions? Tesla has sold millions of vehicles with the promise of self-driving which will seemingly need an upgrade at some point. And many of those vehicles are old enough, at this point, to be retired, despite spending up to $15,000 on a piece of software that has never been delivered to them.
An HW6/AI6 computer will surely have all sorts of new whizbang capabilities, but we were promised those capabilities years ago, and they’re still not delivered yet.
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A group of Senate Democrats has probed Federal Housing Finance Agency director William Pulte over his order to propose how to consider crypto in mortgage applications.