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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.

Jackie Fortir: @JackieFortier Related Topics Health Industry States Hospitals North Carolina Contact Us Submit a Story Tip

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The legendary Nissan GT-R will reemerge, but Godzilla may look a little different

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The legendary Nissan GT-R will reemerge, but Godzilla may look a little different

Nissan has officially confirmed the icon will be making a comeback. Although Nissan is no longer building GT-R models, CEO Ivan Espinosa said Godzilla will “evolve and reemerge” in the future. Here’s what we know so far.

Nissan confirms the GT-R will evolve and reemerge

It seems like we’ve been talking about the next-gen Nissan GT-R for years now. After the last model rolled off the production line at the automaker’s Tochigi plant in Japan on Tuesday, Nissan’s CEO made it clear that the GT-R will be making a comeback.

After bidding farewell to the R35, Espinosa gave the many GT-R fans worldwide hope, saying, “I want to tell you this isn’t a goodbye to the GT-R forever.”

He added that it’s Nissan’s “goal for the GT-R nameplate to one day make a return.” Although this is the end of the line for the R35, the company remains committed to the GT-R nameplate and wants to “reimagine it for a new generation.”

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According to Espinosa, Nissan doesn’t have any finalized plans yet, but he promised that “the GT-R will evolve and reemerge in the future.”

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Nissan’s new N7 electric sedan alongside the GT-R (Source: Dongfeng Nissan)

Nissan says the next Godzilla will ensure the GT-R’s legacy lives on, but will pack even more performance. The big question is, what type of powertrain will it arrive with? Will it be electric? A hybrid? Or, will it still be gas-powered?

At the New York Auto Show in April, Ponz Pandikuthira, Senior Vice President and Chief Planning Officer for Nissan North America, told The Drive that the next GT-R will be a hybrid, rather than an all-electric.

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Nissan’s new N7 electric sedan alongside the GT-R (Source: Dongfeng Nissan)

However, Nissan previewed an electric GT-R a few years ago with the Hyper Force EV concept. The electric sports car concept was promoted as a “game-changing hyper EV” with over 1,300 horsepower (1,000 kW).

All that power is expected to come from solid-state batteries. Just last week, Nissan secured a partnership with LiCAP Technologies to produce all-solid-state EV batteries on a mass scale, one of the biggest hurdles to getting the new technology to market.

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Nissan Hyper Force EV concept (Source: Nissan)

Since Nissan aims to launch its first EV powered by solid-state batteries in 2028, we could see the GT-R reemerge as a plug-in hybrid until the technology is ready.

Either way, it will likely be a few years before we see an electrified Godzilla. If it evolves into an EV or hybrid, it remains up in the air for now.

While Nissan says an all-electric GT-R won’t deliver the performance needed to live up to the nameplate, others are proving otherwise. BYD’s first electric supercar, the Yangwang U9, set a new EV speed record this week after hitting nearly 300 mph.

How do you feel about it? Should the GT-R go all-electric? Or will Nissan settle for a hybrid? Drop us a comment below and let us know which one you’d buy.

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Buckeyes’ orders for Sayin: ‘Just win’ vs. Horns

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Buckeyes' orders for Sayin: 'Just win' vs. Horns

COLUMBUS, Ohio — Ohio State coach Ryan Day has one message for freshman quarterback Julian Sayin, who will be making his first career start for the No. 3 Buckeyes against top-ranked Texas on Saturday.

“Just win,” Day said Tuesday. “Find a way to win.”

All eyes will be on Sayin and new Texas starting quarterback Arch Manning in the showdown at Ohio Stadium. It’s a rematch of last year’s College Football Playoff semifinal when both players watched from the sideline as Will Howard and Ohio State eliminated Quinn Ewers and Texas on the way to winning the national championship.

Both Sayin and Manning were five-star recruits coming out of high school. Manning started two games in Austin last season when Ewers suffered an injury; Sayin attempted only 12 passes last year in mop-up duty.

Day said the Buckeyes aren’t putting “crazy expectations” on Sayin, who beat out Lincoln Kienholz for the starting nod in the preseason.

“Take care of the ball. … If you need to throw it away, throw it away,” Day said of his discussions with Sayin heading into Saturday. “Don’t worry about anything else other than winning the game. That’s the most important thing — that’s the job of the quarterback.”

Ohio State will debut eight new starters after losing the bulk of last season’s championship defense to the NFL. Day said facing Manning will pose a “tremendous” challenge for the revamped defense.

“Athletic; a big, strong arm; smart; quick release; accurate — all of the above,” Day said of Manning. “I mean, he checks every box.”

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Colorado names transfer Salter QB1 for opener

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Colorado names transfer Salter QB1 for opener

Colorado coach Deion Sanders named Kaidon Salter the Buffaloes’ starting quarterback on Tuesday, ahead of the team’s opener Friday against Georgia Tech.

“The kid has a ton of experience, dual threat, can throw the heck out of the ball as well,” said Sanders. “He’s the guy. He’s the guy at this point.”

Salter, who transferred to Colorado after three years as a starter at Liberty, was the presumed starter but had been competing with five-star true freshman Julian Lewis.

“He’s done it before,” said Sanders. “This is not his first time running out the tunnel and getting the start. … I like what he did in the spring, and he’s growing and growing and growing.”

Sanders credited offensive coordinator Pat Shurmur and volunteer assistant coach Byron Leftwich for their work with Salter.

“I defer to those two coaches to allow me to understand what I see as valid,” said Sanders, who added that he is hopeful Lewis will also get game reps.

Salter appeared in two games for Liberty in 2021, before starting most of the team’s games of over the next three years. During that span, he threw for 5,889 yards with 56 touchdowns and 17 interceptions. He also ran for 2,006 yards.

He will replace Shedeur Sanders, who started the past two years for Colorado, before being drafted in the fifth round by the Cleveland Browns.

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